Individual
GREGORY BRANSTETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST,CFA,KCSA
Contact information
Practice address
106 COLUMNS PLAZA DR, GLASGOW, KY 42141-8068
(270) 651-9390
(270) 651-8698
Mailing address
106 COLUMNS PLAZA DR, GLASGOW, KY 42141-8068
(270) 651-9390
(270) 651-8698
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
82418
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F817
CERTIFIED FIRST ASSISTANT
KY
Enumeration date
01/24/2007
Last updated
07/08/2007
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