Crandall, Brandon Ray

Crandall, Brandon Ray is an individual health care provider with primary practice located at 1831 W Court St Ste 1, Janesville WI 53548-3406. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Crandall, Brandon Ray can be contacted via phone (608) 754-7463.

Contact Information

Primary practice address
1831 W Court St Ste 1 Janesville WI 53548-3406
Phone: (608) 754-7463
Fax: (608) 754-1437
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 1348-012 Wisconsin

Profile Details

NPI number 1154321727
LBN Legal business name Crandall, Brandon Ray
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154321727 NPPES
Wisconsin MEDICAID 38829600

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