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NPI Code Detail

MEDICARE: KENNETH BRANSON CRM

MEDICARE: KENNETH BRANSON CRM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist20-CRM-273OR

General Provider Information

NPI Number : 1578162145
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH BRANSON CRM
Provider Business Mailing Address
First Line : 389 SW SCALEHOUSE CT STE 130
Second Line :
City : BEND
State : OR
Zip : 97702-3241
Country : US
Telephone Number : 541-306-4446
Fax Number : 541-550-2011
Provider Business Practice Location Address
First Line : 389 SW SCALEHOUSE CT STE 130
Second Line :
City : BEND
State : OR
Zip : 97702-3241
Country : US
Telephone Number : 541-306-4446
Fax Number : 541-550-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2020
Last Update Date : 10/23/2020

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Directions to “ KENNETH BRANSON CRM” Practice Location

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