Organization
BRANTLEY T. JOLLY, M.D. PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANTLEY JOLLY MD (OWNER)
(804) 337-0425
Entity
Organization
Contact information
Practice address
425 CALIFORNIA ST STE 14, SAN FRANCISCO, CA 94104-2102
(804) 337-0425
Mailing address
425 CALIFORNIA ST STE 14, SAN FRANCISCO, CA 94104-2102
(804) 337-0425
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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