Provider Demographics
NPI:1578571634
Name:BRADLEY, AMY ZEIGLER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ZEIGLER
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14428 HOLBROOK CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:COEBURN
Mailing Address - State:VA
Mailing Address - Zip Code:24230-5544
Mailing Address - Country:US
Mailing Address - Phone:276-395-7971
Mailing Address - Fax:276-395-3526
Practice Address - Street 1:501 FRONT ST W
Practice Address - Street 2:MARTY SHOPPING CENTER
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-3607
Practice Address - Country:US
Practice Address - Phone:276-395-2257
Practice Address - Fax:276-395-3526
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist