Individual
MALENA BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5243 BRANCH POINT DR, VALDOSTA, GA 31605-6570
(912) 492-2312
Mailing address
5243 BRANCH POINT DR, VALDOSTA, GA 31605-6570
(912) 492-2312
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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