Individual
DR. BRANDON EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
901 S COTTAGE AVE, NORMAL, IL 61761
(309) 454-8768
Mailing address
1108 EKSTAM DR., APT 3, BLOOMINGTON, IL 61704
(618) 550-7452
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051296064
IL
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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