Individual
MR. BRADLEY WAYNE DEDMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.D.
Contact information
Practice address
213 W BROADWAY ST, SPIRO, OK 74959-2419
(918) 962-2131
(918) 962-5750
Mailing address
213 W BROADWAY ST, SPIRO, OK 74959-2419
(918) 962-2131
(918) 962-5750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12538
OK
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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