Individual
KENT BRANDEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3224 JARVIS DR, LIMA, OH 45807
(419) 996-5757
(419) 996-5913
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-6930
(513) 981-5123
(513) 981-5015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02003466A
IN
207Q00000X
Family Medicine Physician
Primary
34.011107
OH
Other
Enumeration date
10/05/2006
Last updated
10/15/2013
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