Individual
MICAH BRASEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
300 W RANDOLPH, VANDALIA, IL 62471
(618) 283-7100
(618) 997-6250
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010422
IL
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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