Brent Thomas Graceffa, IDC

NPI #1306255641 in Rockton, Illinois

Provider Information

NPI Number: 1306255641
Entity Type: Individual
Name: Brent Thomas Graceffa, IDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Military Health Care Provider - Independent Duty Corpsman
Credential: IDC
Enumeration Date: Aug 12, 2014
Last Updated: Aug 12, 2014

Practice Location

Address: 107 STRAWBRIDGE DR
City: Rockton
State: Illinois
ZIP Code: 61072-2957
Phone: (760) 212-1995

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X	Primary

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