Individual
JOHN M BRANDON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
298 S MAIN ST STE L, COLVILLE, WA 99114-2404
(808) 681-2718
Mailing address
298 S MAIN ST STE L, COLVILLE, WA 99114-2404
(808) 681-2718
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61492266
WA
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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