Individual
MR. BRANDON LAWRENCE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4141 5TH ST NE, COLUMBIA HEIGHTS, MN 55421-2859
(612) 770-7045
Mailing address
4141 5TH ST NE, COLUMBIA HEIGHTS, MN 55421-2859
(612) 770-7045
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
1111952
MN
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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