Individual
KELSIE BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 W 10TH ST, METROPOLIS, IL 62960-1502
(618) 524-4819
Mailing address
110 W 10TH ST, METROPOLIS, IL 62960-1502
(618) 524-4819
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
017338
KY
183500000X
Pharmacist
Primary
051298195
IL
Other
Enumeration date
08/15/2014
Last updated
03/04/2016
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