Individual
RICKY TRAVIS BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2368 E 1035 S, SPANISH FORK, UT 84660-3505
(801) 836-4035
Mailing address
2368 E 1035 S, SPANISH FORK, UT 84660-3505
(801) 836-4035
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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