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Individual

JACK LEWIS BRADLEY II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
630 E LIBERTY ST, YORK, SC 29745-1605
(803) 684-6934
(803) 684-6315
Mailing address
3275 NATURES TRAIL CT, ROCK HILL, SC 29732-9744
(803) 327-2185
(803) 684-6315

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6154
SC

Other

Enumeration date
04/07/2011
Last updated
04/07/2011
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