| Brendan Wadlow, | |
|
14185 W Falcon St, Luke Afb, AZ 85309-1601 | |
| (928) 232-0764 | |
| Not Available |
| Full Name | Brendan Wadlow |
|---|---|
| Gender | Male |
| Speciality | Dietitian, Registered - Nutrition, Pediatric |
| Location | 14185 W Falcon St, Luke Afb, Arizona |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063106821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133VN1004X | Dietitian, Registered - Nutrition, Pediatric | (NU) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Brendan Wadlow, 14185 W Falcon St, Luke Afb, AZ 85309-1601 Ph: (928) 232-0764 | Brendan Wadlow, 14185 W Falcon St, Luke Afb, AZ 85309-1601 Ph: (928) 232-0764 |
Deborah J Robinson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 7219 N Litchfield Rd, Luke Afb, AZ 85309 Phone: 623-856-3830 Fax: 623-856-6656 |
Kirsten M David, RND Dietitian Medicare: Accepting Medicare Assignments Practice Location: 7219 N Litchfield Rd, Luke Afb, AZ 85309 Phone: 281-382-6748 |