Individual
RUSSELL TYLER BRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 CEDAR LAKE RD STE S, BILOXI, MS 39532-2107
(228) 641-2880
Mailing address
920 CEDAR LAKE RD STE S, BILOXI, MS 39532-2107
(228) 641-2880
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6476
MS
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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