Individual
BRADLEY ROBERT MUNOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, MS, LAT
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2981
Mailing address
1672 W HARRISON AVE, DECATUR, IL 62526-3439
(217) 853-2440
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.005475
IL
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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