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1801427596
BRANDON BRACY
AVONDALE, AZ
NPI
1801427596
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AZ 5089)
Enumeration Date
2020-01-31
Last Update Date
2020-01-31
Business Address
BRANDON BRACY COTA/L
350 E LA CANADA BLVD
AVONDALE, AZ 85323-1643
Phone number: 623-932-2282
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Mailing Address
BRANDON BRACY COTA/L
19443 W MORNING GLORY DR
BUCKEYE, AZ 85326-5810
Phone number: 330-573-9566
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