Provider Demographics
NPI:1427533082
Name:SAND, BRANDON PATRICK
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:PATRICK
Last Name:SAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 LARAMIE ST APT O
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-7925
Mailing Address - Country:US
Mailing Address - Phone:316-573-7988
Mailing Address - Fax:
Practice Address - Street 1:1125 LARAMIE ST APT O
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-7925
Practice Address - Country:US
Practice Address - Phone:316-573-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer