Organization
BRAINWORKS PEDIATRIC GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE BROCKELMANN (MANAGING PARTNER/OWNER)
(636) 240-8096
Entity
Organization
Contact information
Practice address
2120 BRYAN VALLEY COMMERCIAL DR, O FALLON, MO 63366-3495
(636) 240-8096
(636) 272-4484
Mailing address
2120 BRYAN VALLEY COMMERCIAL DR, O FALLON, MO 63366-3495
(636) 240-8096
(636) 272-4484
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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