BRIAN POWELL

MAYWOOD, IL
NPI1225422330
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208D00000X General Practice
(Licence: IL  036146884)
Enumeration Date2015-03-26
Last Update Date2019-05-30
Business Address
BRIAN POWELL
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 708-327-3436
Mailing Address
BRIAN POWELL
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: