Individual
BRANDON THOMAS HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A
Contact information
Practice address
35 BEL AIRE DR, NEWPORT, VT 05855-4953
(802) 334-2878
Mailing address
5930 CORNERSTONE CT W STE 300, SAN DIEGO, CA 92121-3772
(866) 687-7390
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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