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Individual

DR. JACELYN TAYLOR BRADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
HIRAM W. DAVIS MEDICAL CENTER PHARMACY, W. WASHINGTON STREET, PETERSBURG, VA 23803-0030
(804) 524-7346
(804) 524-4718
Mailing address
PO BOX 4030, W. WASHINGTON STREET, PETERSBURG, VA 23803-0030
(804) 524-7346
(804) 524-4718

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202205891
VA
1835P1300X
Psychiatric Pharmacist
0202205891
VA

Other

Enumeration date
10/24/2006
Last updated
09/11/2025
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