Individual
MR. BRANDON STEPHEN LIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3516 NW CORONADO ST, CORVALLIS, OR 97330-4695
(541) 360-3175
Mailing address
1161 SW SEQUOIA LN, DALLAS, OR 97338-1484
(541) 740-3140
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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