Individual
TANYA C BRALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1792
SC
Other
Enumeration date
01/23/2007
Last updated
12/17/2014
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