Individual
MRS. KELSEY GRANT BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
400 S MAIN ST STE B2, MAULDIN, SC 29662-2251
(864) 300-0113
Mailing address
400 S MAIN ST STE B2, MAULDIN, SC 29662-2251
(864) 300-0113
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
N23108789
SC
247ZC0005X
Clinical Laboratory Director (Non-physician)
—
SC
335E00000X
Prosthetic/Orthotic Supplier
Primary
WE8BZQE1EK
SC
Other
Enumeration date
12/14/2023
Last updated
08/06/2025
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