Individual
JEAN BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3805 80TH ST, KENOSHA, WI 53142-4997
(262) 694-0750
Mailing address
3805 80TH ST, KENOSHA, WI 53142-4997
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051296862
IL
183500000X
Pharmacist
Primary
17288
WI
183500000X
Pharmacist
PHA.0020488
CO
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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