Individual
BRANDON O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1425 COLUMBUS AVE, LEBANON, OH 45036-8258
(513) 228-7340
Mailing address
9997 CARVER RD, BLUE ASH, OH 45242-5537
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
86089674
OH
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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