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Individual

BRADY M SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2650 W KEARNEY ST, SPRINGFIELD, MO 65803-2037
(417) 865-1547
Mailing address
2749 N WASHINGTON AVE, SPRINGFIELD, MO 65803-3562
(417) 825-5510

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2022026006
MO
390200000X
Student in an Organized Health Care Education/Training Program
2018039951
MO

Other

Enumeration date
08/05/2021
Last updated
07/07/2022
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