Individual
BRIANNA NICOLE KRELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Mailing address
201 S 14TH ST, HERRIN, IL 62948-3631
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
1972147213
IL
225X00000X
Occupational Therapist
Primary
056010390
IL
225X00000X
Occupational Therapist
1972147213
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
10/30/2019
Last updated
02/06/2020
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