Individual
BRADLEY HIRCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 2ND AVE NE, LITTLE FALLS, MN 56345
(320) 632-2380
(320) 632-3079
Mailing address
1101 2ND AVE NE, LITTLE FALLS, MN 56345-2943
(320) 632-2380
(320) 632-3079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115636
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115636
PROVIDER
MN
Enumeration date
04/11/2017
Last updated
04/11/2017
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