Individual
BRANDON THOMAS HALSTEAD
Active
Individual
BRANDON THOMAS HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
09204
OR
172V00000X
Community Health Worker
9406205-2404
UT
172V00000X
Community Health Worker
PTA.0013570
CO
172V00000X
Community Health Worker
Primary
TEI004216
PA
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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