Individual
BRANDON JAMES MOODY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 S MADISON ST, ADRIAN, MI 49221-2518
(517) 265-5161
Mailing address
5333 MAIN ST APT 104, SYLVANIA, OH 43560-2142
(419) 708-4547
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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