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Individual

BROOKE ALISA OSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
11531 SUNDERLAND ROAD, MARION, IL 62959
(618) 964-5139
Mailing address
311 CIRCLE DR, CREAL SPRINGS, IL 62922-3872
(618) 964-4166

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043122198
IL

Other

Enumeration date
07/27/2017
Last updated
07/27/2017
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