Individual
BRIAN AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W VISTA WAY, VISTA, CA 92083-5732
(760) 724-9112
Mailing address
550 W VISTA WAY, VISTA, CA 92083-5732
(760) 724-9112
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/13/2008
Last updated
06/13/2008
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