Brandon Gillow
Student in an Organized Health Care Education/Training Program in Bangor, PA. Individual provider (NPI-1).
NPI number1750737987
StatusActive
Last updated in NPPESMay 6, 2016
Details
- NPI
- 1750737987
- Entity type
- Individual (NPI-1)
- Name
- Brandon Gillow
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 6, 2016
- Last updated
- May 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
535 Pennsylvania AveBangor, PA 18013-1860
Phone 484-553-3684
Mailing address
535 Pennsylvania AveBangor, PA 18013-1860
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