Individual
BRANDON KYLE LONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 HARVARD DR, OWENSBORO, KY 42301-6152
(270) 240-1842
Mailing address
3130 DAVIESS ST, OWENSBORO, KY 42303-6331
(270) 230-6192
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KY
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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