Individual
BRANDON SMALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 W BERKS ST, PHILADELPHIA, PA 19121-1801
(215) 684-5083
Mailing address
266 W WENDY WAY, KING OF PRUSSIA, PA 19406-3483
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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