Individual
BRADLEY DAVID BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
501 GERVAIS ST, COLUMBIA, SC 29201-3045
(803) 255-6101
Mailing address
501 GERVAIS ST, COLUMBIA, SC 29201-3045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
43642
SC
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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