Individual
BRADT J FATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
Mailing address
300 N EAST TELLICO RD, ATOKA, OK 74525-4338
(580) 628-1533
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14490
OK
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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