Individual
BRENON WITTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3975 MIDWAY DR, BAKER CITY, OR 97814
(541) 406-4999
Mailing address
PO BOX 1005, BAKER CITY, OR 97814-1005
(541) 406-4999
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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