Individual
MIRA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
3201 S IOWA ST, LAWRENCE, KS 66046-5205
(785) 832-0312
Mailing address
3201 S IOWA ST, LAWRENCE, KS 66046-5205
(785) 832-0312
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-13766
KS
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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