Individual
MR. BRANDON MANCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6700 ANTIOCH RD, SUITE 430, MERRIAM, KS 66204-1258
(913) 652-9229
Mailing address
6700 ANTIOCH RD, SUITE 430, MERRIAM, KS 66204-1258
(913) 652-9229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2007037023
MO
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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