Doctor Name: | ANTHONY W BRANDENBURG |
NPI Number: | 1013166206 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 070404648 |
Business Practice Address: | 118 Ike Anderson Ln Clinton, TN - 377166575 |
Business Phone Number: | 8654637151 |
Business Fax Number: | 8654637151 |
Mailing Address: | 118 Ike Anderson Ln, CLINTON |
State: | TN |
Postal Code: | 377166575 |
Phone Number: | 8654637151 |
Fax Number: | 8654637151 |
NPI Enumeration Date: | 09/12/2008 |
NPI Last Update Date: | 09/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 070404648 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |