Individual
BRANDY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3692 HERMOSA DR, DAYTON, OH 45416-1118
(937) 567-2456
Mailing address
3692 HERMOSA DR, DAYTON, OH 45416-1118
(937) 567-2456
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
148351
OH
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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