Provider Demographics
NPI:1346718848
Name:MASON, BRANDON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:MASON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4907
Mailing Address - Country:US
Mailing Address - Phone:563-202-8077
Mailing Address - Fax:
Practice Address - Street 1:321 17TH ST
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4907
Practice Address - Country:US
Practice Address - Phone:563-202-8077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA093999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor