Individual
BRANDI FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 W MAIN ST STE 3K, BELLEVILLE, IL 62223-3806
(618) 578-3627
Mailing address
1600 LORETTA AVE, CAHOKIA, IL 62206-2305
(618) 578-3627
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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