Organization
PT MED
Active
Other names
Bracit
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN SCOTT DAVENPORT (PRESIDENT)
(678) 687-5871
Entity
Organization
Contact information
Practice address
1111 E LAKE DR, GAINESVILLE, GA 30506-1725
(678) 687-5871
Mailing address
1111 E LAKE DR, GAINESVILLE, GA 30506-1725
(678) 687-5871
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/12/2006
Last updated
08/22/2020
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