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Individual

BRUCE T WREATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
900 N WASHINGTON ST, DU QUOIN, IL 62832-1230
(618) 542-2146
Mailing address
8213 NW 79TH TER, KANSAS CITY, MO 64152-4206
(618) 318-2350

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
24046
IL

Other

Enumeration date
07/10/2006
Last updated
07/08/2007
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