Individual
J BRADLEY MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1477 STATE HIGHWAY 248, BRANSON, MO 65616-7477
(417) 337-9529
Mailing address
1477 STATE HIGHWAY 248, BRANSON, MO 65616-7477
(417) 337-9529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2006012347
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006012347
PHARMACIST
MO
Enumeration date
08/10/2015
Last updated
08/10/2015
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