Individual
JEREMY BRANDT JENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5475 ESSEN LN, BATON ROUGE, LA 70809-3737
(225) 767-8493
Mailing address
5475 ESSEN LN, BATON ROUGE, LA 70809-3737
(225) 767-8493
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
200142
LA
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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