Individual
BRANDON DAVID MUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-7777
Mailing address
830 GARDENBROOK CIR APT H, INDIANAPOLIS, IN 46202-4657
(812) 374-9006
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/16/2019
Last updated
03/16/2019
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