Individual
ROGER BARRY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1537 CHARLESTON HWY, WEST COLUMBIA, SC 29169-5047
(803) 796-3392
Mailing address
6510 DARE CIR, COLUMBIA, SC 29206-1153
(803) 240-8891
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13701
SC
Other
Enumeration date
07/18/2012
Last updated
12/10/2012
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