Individual
BRADLEY DAVID DEDIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
Mailing address
1150 EWING ST APT 316, FORT WAYNE, IN 46802-3367
(309) 824-1695
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051300511
IL
183500000X
Pharmacist
Primary
26027863A
IN
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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