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1205239670
ISAAC SANDIDGE
ALTON, IL
NPI
1205239670
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2014-09-30
Last Update Date
2014-09-30
Business Address
ISAAC SANDIDGE
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
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Mailing Address
ISAAC SANDIDGE
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
Copy
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