Individual
MR. BRANDON CLINTON ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12091 SORRENTO ST, DETROIT, MI 48227-3751
(313) 397-1884
Mailing address
PO BOX 2172, SOUTHFIELD, MI 48037-2172
(313) 685-7811
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
432065203
MI
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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