Individual
BRANDON MICHAEL LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
677 ELY ST, ALLEGAN, MI 49010-1541
(269) 270-7799
Mailing address
BRANDON LANGE 3285 122ND AVENUE, ALLEGAN, MI 49010
(269) 673-6671
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
5202007638
MI
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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