Individual
BRANDON ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
323 FOUNTAIN WAY, HAMPTON, VA 23666-4221
(818) 447-2004
Mailing address
323 FOUNTAIN WAY, HAMPTON, VA 23666-4221
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
0002090007
VA
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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