Individual
MR. BRADLEY GLENN MCBETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 DR. MARTIN LUTHER KING JR. DRIVE, PEORIA, IL 61605-2400
(309) 497-0790
(309) 497-3567
Mailing address
706 W DEARBORN ST, ELMWOOD, IL 61529-9407
(309) 742-8197
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0051039895
IL
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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