Individual
MR. BRANDON POMAIKAI PENEBACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
TAGAYTA DR BLDG C-1722, FORT BRAGG, NC 28310-0001
(910) 907-8282
Mailing address
504 MURRAY FORK DR, FAYETTEVILLE, NC 28314-0958
(910) 973-2530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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