Individual
BRIAN TIMOTHY MCANULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 233-7750
Mailing address
1517 CHESTERFIELD CT, SWANSEA, IL 62226-8531
(618) 233-2511
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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