Individual
MR. BRENT MAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
550 POPE AVE, MUNSON ARMY HEALTH CENTER (ATTN: CRENTIALS), FORT LEAVENWORTH, KS 66027-2332
(903) 684-6562
Mailing address
550 POPE AVE, MUNSON ARMY HEALTH CENTER (ATTN: CRENTIALS), FORT LEAVENWORTH, KS 66027-2332
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28145659A
IN
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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