Individual
MICHELLE BRACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
502 HALL RD, THOMASVILLE, GA 31757-8105
(229) 224-7423
Mailing address
502 HALL RD, THOMASVILLE, GA 31757-8105
(229) 225-3917
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN173440
GA
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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