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1487943056
BRIAN DALE SOUTH
SPRINGFIELD, MO
NPI
1487943056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: MO MO 2011008666)
Enumeration Date
2011-04-04
Last Update Date
2011-04-04
Business Address
MR. BRIAN DALE SOUTH
2131 S EASTGATE AVE
SPRINGFIELD, MO 65809-2146
Phone number: 417-763-3309
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Mailing Address
MR. BRIAN DALE SOUTH
2131 S EASTGATE AVE
SPRINGFIELD, MO 65809-2146
Phone number: 417-763-3309
Copy
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