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1457170110
BRANDAN LEE HOSTAR
COLUMBIA, SC
NPI
1457170110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
Enumeration Date
2024-10-08
Last Update Date
2024-10-08
Business Address
BRANDAN LEE HOSTAR PTA
3800 FOREST DR STE B101
COLUMBIA, SC 29204-4146
Phone number: 803-764-2363
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Mailing Address
BRANDAN LEE HOSTAR PTA
150 HIGHLAND CENTER DR STE B
COLUMBIA, SC 29203-9247
Phone number: 803-699-9775
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