MARY L BRANDENBURG

CARBONDALE, IL
NPI1649385873
Former NameMARY L BRECHT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085-001021)
Enumeration Date2006-08-20
Last Update Date2012-09-13
Business Address
-- MARY L BRANDENBURG PA
1301 E WALNUT ST
CARBONDALE, IL 62901-5004
Phone number: 618-457-3371
Mailing Address
-- MARY L BRANDENBURG PA
PO BOX 577
CARTERVILLE, IL 62918-0577
Phone number: 618-985-8221
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