Individual
BENJAMIN TYLER BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19629 NE 23RD ST, HARRAH, OK 73045-9305
(405) 454-0010
(405) 454-0030
Mailing address
PO BOX 746, HARRAH, OK 73045-0746
(405) 454-0010
(405) 454-0030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2015
MO
225100000X
Physical Therapist
Primary
5233
OK
Other
Enumeration date
09/30/2015
Last updated
09/28/2016
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