Individual
LETICIA YVONNE BRAZIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MILITARY PROVIDER
Contact information
Practice address
331 SIJAN AVE., WHITEMAN AFB, MO 65305-5001
(940) 704-8099
Mailing address
207 SW T HWY, KINGSVILLE, MO 64061-9229
(940) 704-8099
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
M5025933
GA
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/10/2012
Last updated
02/17/2022
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