Individual
BRANDON WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
136 CORPORATE PARK DR, MOORESVILLE, NC 28117-6959
(704) 360-2796
Mailing address
3009 BERMUDA BAY LN APT 104, MEBANE, NC 27302-9870
(919) 951-8987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A7727
NC
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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