Individual
MR. JERRY LEE BRAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
618 RIDENOUR RD, GAHANNA, OH 43230-2067
(614) 207-7578
Mailing address
618 RIDENOUR RD, GAHANNA, OH 43230-2067
(614) 207-7578
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33-020021
OH
Other
Enumeration date
04/18/2012
Last updated
12/24/2012
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