Individual
TRACI ANN BREDENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
201 N MAIN ST STE 210, SAINT CHARLES, MO 63301-2878
(618) 207-8869
Mailing address
201 N MAIN ST STE 210, SAINT CHARLES, MO 63301-2878
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
2018043155
MO
405300000X
Prevention Professional
2018043155
MO
Other
Enumeration date
04/05/2019
Last updated
07/23/2019
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