Individual
ALPHONSUS M BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2510 E WASHINGTON ST, APT #13, BLOOMINGTON, IL 61704-4447
(309) 660-4210
Mailing address
2510 EAST WASHINGTON ST, APT #13, BLOOMINGTON, IL 61704
(309) 660-4210
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051296175
IL
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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