Organization
BRACEVILLE SD 75
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL SANBURG (DIRECTOR)
(815) 942-5780
Entity
Organization
Contact information
Practice address
209 N MITCHELL ST, BRACEVILLE, IL 60407-9068
(815) 237-8040
Mailing address
209 N MITCHELL ST, BRACEVILLE, IL 60407-9068
(815) 237-8040
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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