Healthcare Provider Details

I. General information

NPI: 1922429331
Provider Name (Legal Business Name): BRANDON COLDREN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 MARKET PL
SALINA KS
67401-8598
US

IV. Provider business mailing address

2919 MARKET PL
SALINA KS
67401-8598
US

V. Phone/Fax

Practice location:
  • Phone: 785-515-6008
  • Fax:
Mailing address:
  • Phone: 785-515-6008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1413
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: