Provider Demographics
NPI:1750829578
Name:MOW, BRANDY EILEEN
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:EILEEN
Last Name:MOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:EILEEN
Other - Last Name:VETTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:715 HORIZON DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2808 NORTH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-5155
Practice Address - Country:US
Practice Address - Phone:970-241-6023
Practice Address - Fax:970-683-7277
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist