Individual
JUSTIN ROBERT BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
164 HOLDEN RD, MOUNT GAY, WV 25637-1126
(304) 239-2020
Mailing address
PO BOX 64, MATEWAN, WV 25678-0064
(606) 471-9872
(304) 239-3468
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0013159
WV
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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