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Individual
BRANDON TODD SIMON
Active
Individual
BRANDON TODD SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11400
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11400
PT LICENSE
LA
Enumeration date
12/09/2022
Last updated
12/09/2022
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