Individual
BRANDON TERRELL HANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2620 INDUSTRY WAY, LYNWOOD, CA 90262-4024
(310) 667-4070
Mailing address
2620 INDUSTRY WAY, LYNWOOD, CA 90262-4024
(310) 667-4070
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
225400000X
Rehabilitation Practitioner
A4262799
CA
Other
Enumeration date
04/27/2010
Last updated
10/01/2019
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