Individual
ANTHONY W BRANDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 IKE ANDERSON LN, CLINTON, TN 37716-6575
(865) 463-7151
(865) 463-7151
Mailing address
118 IKE ANDERSON LN, CLINTON, TN 37716-6575
(865) 463-7151
(865) 463-7151
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
070404648
TN
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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