Individual
BRANDON SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1990 ASHLEY ST, PHILADELPHIA, PA 19138-2725
(267) 616-8686
Mailing address
1990 ASHLEY ST, PHILADELPHIA, PA 19138-2725
(267) 616-8686
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
26051554
PA
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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