Individual
BRENDON T CASSITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 W WINCHESTER ST STE 200, MURRAY, UT 84107-7710
(239) 920-2020
Mailing address
6069 LUCAYA WAY, NAPLES, FL 34113-8825
(239) 920-2020
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
347C00000X
Private Vehicle
Primary
149735287
UT
Other
Enumeration date
10/23/2019
Last updated
10/29/2020
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