BRITTAIN UTAH LADD

PEORIA, IL
NPI1033647417
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IL  036176631)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
207P00000X Emergency Medicine
(Licence: MO  2020020206)
Enumeration Date2017-05-30
Last Update Date2025-09-23
Business Address
BRITTAIN UTAH LADD DO
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2553
Mailing Address
BRITTAIN UTAH LADD DO
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2553