| Amy And Brandon Pung, Llc | |
|
2031 Rambling Rd Kalamazoo MI 49008-1632 | |
| (269) 993-7670 | |
| Not Available |
| Full Name | Amy And Brandon Pung, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2031 Rambling Rd, Kalamazoo, Michigan |
| Authorized Official Name and Position | Brandon Pung (THERAPIST) |
| Authorized Official Contact | 2699937672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy And Brandon Pung, Llc 4356 Squire Heath Rd Portage MI 49024-4060 Ph: (269) 993-7672 | Amy And Brandon Pung, Llc 2031 Rambling Rd Kalamazoo MI 49008-1632 Ph: (269) 993-7670 |
| NPI Number | 1568823300 |
|---|---|
| Provider Enumeration Date | 03/07/2016 |
| Last Update Date | 03/07/2016 |
| Medicare PECOS PAC ID | 2567759145 |
|---|---|
| Medicare Enrollment ID | O20160926000870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568823300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801084659 (Michigan) | Primary |
| Provider Name | Brandon P Pung |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912135302 PECOS PAC ID: 8426104050 Enrollment ID: I20090922000764 |
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