Provider Demographics
NPI:1851386502
Name:BRADLEY, LEE ANN (RPH, PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANN
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:RPH, PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4008
Mailing Address - Country:US
Mailing Address - Phone:406-329-5617
Mailing Address - Fax:406-329-5697
Practice Address - Street 1:500 W BROADWAY ST
Practice Address - Street 2:MONTANA SPINE CENTER
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4003
Practice Address - Country:US
Practice Address - Phone:406-329-5617
Practice Address - Fax:406-329-5697
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT27341835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy