Individual
BRADY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1075 E MAIN ST, PRICE, UT 84501-2712
(435) 630-0840
(435) 637-4628
Mailing address
1075 E MAIN ST, PRICE, UT 84501-2712
(435) 630-0840
(435) 637-4628
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6729361
UT
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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