Individual
BRANDARIUS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6309 PORTOLA RD, LAS VEGAS, NV 89108-3920
(702) 300-0630
Mailing address
6309 PORTOLA RD, LAS VEGAS, NV 89108-3920
(702) 300-0630
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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