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Individual

BRIAN MICHAEL KNEBEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
1205 W FERDON ST, LITCHFIELD, IL 62056-4454
(217) 324-6197
Mailing address
1205 W FERDON ST, LITCHFIELD, IL 62056-4454
(217) 324-6197

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288337
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1841217114
IL
Enumeration date
10/25/2020
Last updated
10/25/2020
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