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1306401260
BRANDON BLAKELY BISSO
LAGRANGE, GA
NPI
1306401260
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN220792)
Enumeration Date
2019-05-07
Last Update Date
2019-05-07
Business Address
Mr. BRANDON BLAKELY BISSO NP
1514 VERNON RD
LAGRANGE, GA 30240-4131
Phone number: 706-882-1411
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Mailing Address
Mr. BRANDON BLAKELY BISSO NP
10545 SUMMER CREEK DR
ALPHARETTA, GA 30022-5084
Phone number: 706-631-5247
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