Individual
MR. BRANDON BACCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5860 S PECOS RD STE 300, LAS VEGAS, NV 89120-5429
(702) 538-9474
Mailing address
PO BOX 371535, LAS VEGAS, NV 89137-1535
(702) 371-7008
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1603764135
NV
Other
Enumeration date
05/20/2014
Last updated
05/20/2014
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