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Individual

BRANDON LEE NISSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3381 DEER VALLEY RD, ANTIOCH, CA 94531-6664
(925) 757-7571
(925) 757-7114
Mailing address
1342 E COVEY RUN CT, EAGLE, ID 83616-4273
(925) 584-8166

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC36545
ID

Other

Enumeration date
03/02/2023
Last updated
01/15/2024
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