Individual
BRENDAN WADLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4410 N 99TH AVE APT 2072, PHOENIX, AZ 85037-5944
(928) 232-0764
Mailing address
4410 N 99TH AVE APT 2072, PHOENIX, AZ 85037-5944
(928) 232-0764
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
09/11/2025
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