Individual
BRANDON KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
437 WILSON ST, BREWER, ME 04412-1414
(207) 991-9679
Mailing address
152 OLD MILL RD, SANFORD, ME 04073-4222
(207) 459-0375
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR68766
ME
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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