Individual
DR. BRANDON J. FANTASIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
410 N LEMON ST, ONTARIO, CA 91764-3732
(909) 984-2765
(909) 467-5594
Mailing address
410 N LEMON ST, ONTARIO, CA 91764-3732
(909) 984-2765
(909) 467-5594
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
33564
CA
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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