Individual
TERRENCE BRANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 TARPAN CT, FAIRBURN, GA 30213-4800
(770) 892-8332
(770) 626-3262
Mailing address
3766 CHAPEL CV, DOUGLASVILLE, GA 30135-2885
(770) 892-8332
(470) 401-1105
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
060-R-2073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060-R-2073
—
GA
Enumeration date
02/02/2019
Last updated
05/17/2021
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