Most Relevant Information
Provider Data
| NPI Number: | 1003276767 |
| Provider Name: | BRANDY MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 148351 |
Most Important Dates
| Enumeration Date: | 02/24/2016 |
| Last Updated: | 02/24/2016 |
Provider Practice Location
3692 HERMOSA DR
DAYTON
OH
454161118
Practice Location Phone/Fax
| Phone: | 9375672456 |
| Fax: |
Provider Mailing Location
3692 HERMOSA DR
DAYTON
OH
454161118
Provider Mailing Phone/Fax
| Phone: | 9375672456 |
| Fax: |