Individual
KATHERINE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
772 WALL ST STE B, O FALLON, IL 62269-1959
(618) 624-2400
(618) 624-2407
Mailing address
772 WALL ST STE B, O FALLON, IL 62269-1959
(618) 624-2400
(618) 624-2407
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004885
IL
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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