Individual ProviderBrandon WoltersStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1 Wyoming Street, Bg020, Dayton, OH 45409(937) 208-2850PECOS EnrollmentBased on the most recent information from CMS, provider Brandon Wolters is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1467204040Provider TypeIndividualFull NameWolters, BrandonGenderMaleSole ProprietorNoEnumeration Date4/4/2024Last Updated4/4/2024Contact InformationPractice LocationPractice Address1 Wyoming Street, Bg020, Dayton, OH 45409Phone(937) 208-2850FaxUnlisted FaxMailing LocationMailing Address1 Wyoming Street, Bg020, Dayton, OH 45409Phone(937) 208-2850FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer