Individual
BRADLEY JOHN STOICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH BSPHARM
Contact information
Practice address
911 N MAIN ST, HAILEY, ID 83333-8608
(208) 788-6716
Mailing address
PO BOX 2153, 206 MEADOWS LOOP, KETCHUM, ID 83340
(406) 531-7693
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
2574
MT
183500000X
Pharmacist
Primary
P6590
ID
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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