Individual
BRADLEY ALEN SANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1188 SOUTH STATE ROUTE 157, EDWARDSVILLE, IL 62025
(618) 220-1234
Mailing address
20 CORVETTE DR, LITCHFIELD, IL 62056-1038
(217) 324-3400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209019065
IL
Other
Enumeration date
03/27/2019
Last updated
07/15/2020
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