Provider Demographics
NPI:1336181049
Name:BRIAN JOSEPHS LLC
Entity Type:Organization
Organization Name:BRIAN JOSEPHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:CLEMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-649-6405
Mailing Address - Street 1:10560 BARKLEY ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1811
Mailing Address - Country:US
Mailing Address - Phone:913-649-6405
Mailing Address - Fax:913-768-4475
Practice Address - Street 1:10560 BARKLEY ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1811
Practice Address - Country:US
Practice Address - Phone:913-649-6405
Practice Address - Fax:913-768-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier