Individual
SCOTT BRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
1008 MICHAELWOOD DR, VIRGINIA BEACH, VA 23452-4612
(757) 348-7101
(757) 855-1192
Mailing address
1008 MICHAELWOOD DR, VIRGINIA BEACH, VA 23452-4612
(757) 348-7101
(757) 855-1192
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
4404
VA
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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