| |
130 E Lockling St, Brookfield, MO 64628 | |
(660) 258-2222 | |
(660) 258-5668 |
Full Name | |
---|---|
Type | Facility |
Speciality | Dietitian, Registered |
Location | 130 E Lockling St, Brookfield, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427251750 | NPI | - | NPPES |
358970002 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 20001006915 (Missouri) | Primary |
Mailing Address | Practice Location Address |
---|---|
130 E Lockling St, Brookfield, MO 64628-2337 Ph: (660) 258-2222 | 130 E Lockling St, Brookfield, MO 64628 Ph: (660) 258-2222 |
Pamela Brown, RD/LD Dietitian Medicare: Medicare Enrolled Practice Location: 130 East Lockling, Brookfield, MO 64628 Phone: 660-258-2222 |