Individual
LORI R. BREEDLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 269-5400
(417) 269-7212
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R3K31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206697708
—
MO
Enumeration date
06/24/2005
Last updated
10/09/2023
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