Graceffa, Brent Thomas

Graceffa, Brent Thomas is an sole proprietor health care provider with primary practice located at 107 Strawbridge Dr , Rockton IL 61072-2957. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Graceffa, Brent Thomas can be contacted via phone (760) 212-1995.

Contact Information

Primary practice address
107 Strawbridge Dr Rockton IL 61072-2957
Phone: (760) 212-1995
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1306255641
LBN Legal business name Graceffa, Brent Thomas
Credentials IDC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2014
Last updated Aug 12th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers