Individual
MR. BRANDON MARTEL INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
185 GRIGSBY LN, 104, CORDOVA, TN 38018-4838
(901) 756-5658
Mailing address
185 GRIGSBY LN, 104, CORDOVA, TN 38018-4838
(901) 756-5658
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
01/18/2011
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