Individual
DR. BRAD BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1790 DEER VALLEY DR, IDAHO FALLS, ID 83401-6800
(208) 520-0088
Mailing address
535 E 17TH ST, IDAHO FALLS, ID 83404-6154
(208) 542-4569
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5358
ID
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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