Individual
MR. BRANDYN SHANE CHARLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC
Contact information
Practice address
700 COLLEGE PLACE, LYCOMING COLLEGE, WILLIAMSPORT, PA 17701-5192
(570) 321-4271
(570) 321-4158
Mailing address
3 ASHLEE LN, DANVILLE, PA 17821-9774
(570) 275-6735
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001818A
PA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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