Provider Demographics
NPI:1427313337
Name:BRIAN JOSEPHS INTERNATIONAL LLC
Entity type:Organization
Organization Name:BRIAN JOSEPHS INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-649-8844
Mailing Address - Street 1:5401 COLLEGE BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1923
Mailing Address - Country:US
Mailing Address - Phone:913-649-6405
Mailing Address - Fax:913-649-7727
Practice Address - Street 1:5401 COLLEGE BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1923
Practice Address - Country:US
Practice Address - Phone:913-649-6405
Practice Address - Fax:913-649-7727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier