Individual
JESSICA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2094 EE WALLACE BLVD N, FERRIDAY, LA 71334-2233
(318) 757-8172
(318) 757-0762
Mailing address
2094 EE WALLACE BLVD N, FERRIDAY, LA 71334-2233
(318) 757-8172
(318) 757-0762
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-010421
MS
183500000X
Pharmacist
Primary
PST.018571
LA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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