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Individual

MISS BRANDI ROSE KIRBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Mailing address
3302 W MAIN ST, MARION, IL 62959-4863
(618) 599-6966

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.011838
IL

Other

Enumeration date
08/14/2017
Last updated
04/03/2019
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