Individual
LAKISHA BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9332 MARBARRY DR, FAIRVIEW HEIGHTS, IL 62208-1141
(618) 971-9676
Mailing address
9332 MARBARRY DR, FAIRVIEW HEIGHTS, IL 62208-1141
(618) 971-9676
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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