Organization
BRAVO HEALTH ADVANCED CARE CENTER, P.C.
Active
Organization
BRAVO HEALTH ADVANCED CARE CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIRK WALES MD (PRESIDENT)
(615) 236-6100
Entity
Organization
Contact information
Practice address
1601 CHESTNUT ST, PHILADELPHIA, PA 19192-4071
(267) 238-5825
(855) 803-5322
Mailing address
1500 SPRING GARDEN ST STE 800, PHILADELPHIA, PA 19130-4071
(267) 238-5825
(855) 803-5322
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD038974E
PA
Other
Enumeration date
04/01/2009
Last updated
12/03/2019
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