Individual
BRANDON LEVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
42 JESSICA CT, ALLENHURST, GA 31301-2515
(321) 634-2847
Mailing address
42 JESSICA CT, ALLENHURST, GA 31301-2515
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326711
TX
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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