Individual
MARION BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
20 N MAIN ST, BEACON FALLS, CT 06403-1131
(203) 729-4567
(203) 729-4573
Mailing address
PO BOX 218, BEACON FALLS, CT 06403-0218
(203) 729-4567
(203) 729-4573
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0006934
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004253548
—
CT
Enumeration date
03/07/2016
Last updated
03/07/2016
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