Individual
BRANDI LEE GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53 EDGEWOOD DR, SHELBY, OH 44875-1811
(419) 775-6393
Mailing address
53 EDGEWOOD DR, SHELBY, OH 44875-1811
(419) 775-6399
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
OH
376J00000X
Homemaker
Primary
—
OH
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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