MEDICARE: MRS. COURTNEY BRANDON

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
1	172A00000X	Driver		OH

General Provider Information

NPI Number	:	1891685327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY BRANDON

Provider Business Mailing Address
First Line	:	6006 AVIATION TRL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-7433
Country	:	US
Telephone Number	:	937-432-8923
Fax Number	:

Provider Business Practice Location Address
First Line	:	6006 AVIATION TRL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-7433
Country	:	US
Telephone Number	:	937-432-8923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/07/2025

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Directions to “ MRS. COURTNEY BRANDON ” Practice Location

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