Individual
BRANDON DIPASQUALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3716 MS-39, MERIDIAN, MS 39301
(601) 482-7164
Mailing address
5381 W LAKE RD, CONESUS, NY 14435-9328
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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