Individual
BRADLEY JAY POE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
84 GUADALUPE LANE, TUBAC, AZ 85646
(520) 398-9801
Mailing address
PO BOX 4512, TUBAC, AZ 85646-4512
(520) 398-9801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S007459
AZ
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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