Individual
BRANDON HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1631 RITTER DR, DANIELS, WV 25832-9264
(304) 763-3051
Mailing address
105 CORNERSTONE CT, MOUNT HOPE, WV 25880-9512
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001634
WV
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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