Individual
BRAD ANTHONY DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
417 S TOWER AVE, CENTRALIA, WA 98531-3917
(360) 736-4433
(360) 736-8709
Mailing address
417 S TOWER AVE, CENTRALIA, WA 98531-3917
(360) 736-4433
(360) 736-8709
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00070055
WA
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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