Individual
BRANDON ROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1244 MADISON AVE, EDWARDSVILLE, IL 62025-2328
(217) 621-4573
Mailing address
1244 MADISON AVE, EDWARDSVILLE, IL 62025-2328
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Enumeration date
12/27/2021
Last updated
12/27/2021
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