Organization
BRANDON REHABILITATION, LLC
Active
Organization
BRANDON REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN EUGENE BRANDON PT (OWNER)
(336) 940-6415
Entity
Organization
Contact information
Practice address
5380 US HIGHWAY 158, SUITE 205, ADVANCE, NC 27006-6907
(336) 940-6415
(336) 940-6410
Mailing address
5380 US HIGHWAY 158, SUITE 205, ADVANCE, NC 27006-6907
(336) 940-6415
(336) 940-6410
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6215
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7210626
—
NC
Enumeration date
10/11/2006
Last updated
04/21/2010
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