Provider Demographics
NPI:1518310457
Name:WEST, BRANDI (LAC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5019 LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64129-1979
Mailing Address - Country:US
Mailing Address - Phone:720-934-8765
Mailing Address - Fax:
Practice Address - Street 1:7235 CENTRAL ST
Practice Address - Street 2:#14
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5717
Practice Address - Country:US
Practice Address - Phone:816-237-8356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016022151171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist