Individual
MS. CRYSTAL BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 GLACE RD, COLLEGE PARK, GA 30349-4628
(404) 503-6483
Mailing address
PO BOX 91, GALLOWAY, OH 43119-0091
(614) 378-7055
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
14017845
GA
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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