Individual
KYNAN ALEXANDER BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 665-5996
(309) 662-7143
Mailing address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701
(309) 665-5996
(309) 662-7143
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
03/22/2024
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