Individual
MR. BRAD S KOECHLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 N 4TH ST, SPRINGFIELD, IL 62702-5205
(217) 299-2973
Mailing address
401 N 4TH ST, SPRINGFIELD, IL 62702-5205
(217) 299-2973
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
051040085
IL
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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