Individual
BRANDON S LICHTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
30 MEDICAL PARK, STE 223, WHEELING, WV 26003-6391
(304) 243-7879
(304) 243-3901
Mailing address
30 MEDICAL PARK, STE 223, WHEELING, WV 26003-6391
(304) 243-7879
(304) 243-3901
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-0267
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018801
—
WV
01
—
CD2989
RAIL ROAD MEDICARE
WV
Enumeration date
01/16/2008
Last updated
06/23/2011
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