Individual
BRANDON DECAPIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 US HIGHWAY 60 W, MOREHEAD, KY 40351-6130
(606) 783-0404
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
UNLICENSED
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
07/23/2014
Last updated
11/06/2014
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