Individual
COURTNEY BRASELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 W STEPHENSON ST, FREEPORT, IL 61032-4864
(815) 599-6085
(815) 599-6384
Mailing address
421 W EXCHANGE ST, PO BOX 268, FREEPORT, IL 61032-4008
(815) 599-7950
(815) 599-7974
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011511
IL
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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