BRANDON BLAKELY BISSO

LAGRANGE, GA
NPI1306401260
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN220792)
Enumeration Date2019-05-07
Last Update Date2019-05-07
Business Address
Mr. BRANDON BLAKELY BISSO NP
1514 VERNON RD
LAGRANGE, GA 30240-4131
Phone number: 706-882-1411
Mailing Address
Mr. BRANDON BLAKELY BISSO NP
10545 SUMMER CREEK DR
ALPHARETTA, GA 30022-5084
Phone number: 706-631-5247