Individual
BRANDON LEE PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8091 BACK BAY CT APT 2A, DAYTON, OH 45458-1766
(513) 496-6968
Mailing address
8091 BACK BAY CT APT 2A, DAYTON, OH 45458-1766
(151) 359-4062
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
170217
OH
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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