Individual
BRENN KILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
620 W BRIDGEPORT ST, WHITE HALL, IL 62092-1001
(217) 374-2144
Mailing address
427 N STATE ST, ROODHOUSE, IL 62082-1066
(217) 370-0230
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
070012647
IL
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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