Individual
BRADY KORRY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1135 W RIVERDALE RD, RIVERDALE, UT 84405-3722
(801) 392-4772
Mailing address
3724 S 4700 W, WEST HAVEN, UT 84401-9618
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6729808-1701
UT
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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