Individual
BRANDON BOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
13609 CALIFORNIA ST STE 200, OMAHA, NE 68154-5245
(402) 891-1118
Mailing address
13609 CALIFORNIA ST STE 200, OMAHA, NE 68154-5245
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003984
IL
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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