Individual
BRIAN FRANK VAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
407 N BASIN RD, FAIRFIELD, IL 62837-9639
(618) 516-5326
Mailing address
407 N BASIN RD, FAIRFIELD, IL 62837-9639
(618) 516-5326
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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