Individual
KELLEY JOE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
3437 MASONIC DR, ALEXANDRIA, LA 71301-3686
(318) 445-4557
Mailing address
270 BEAR CREEK RD, GEORGETOWN, LA 71432-3700
(318) 827-5242
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18309
LA
Other
Enumeration date
09/17/2009
Last updated
09/17/2009
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