Individual
BRADLEY ALAN AUTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2591 12TH ST, CARLYLE, IL 62231-6499
(618) 594-3658
(618) 594-3670
Mailing address
7 DOWNING PL, GLEN CARBON, IL 62034-1563
(618) 806-4744
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051038194
IL
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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