Individual
GREG BRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1078
(417) 347-1079
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-1078
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
151120
MO
Other
Enumeration date
08/04/2006
Last updated
11/18/2015
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