Individual
MR. BRETT DAVIN ANDRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1640 REDSTONE CENTER DR STE 200, PARK CITY, UT 84098-7607
(435) 645-0788
Mailing address
3516 SW 130TH ST, OKLAHOMA CITY, OK 73170-5422
(405) 759-2008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A707
OK
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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