Organization
BRAVO THERAPY AND INDEPENDENT LIVING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIRAM JAIR CORONA MARTINEZ (MANAGING MEMBER)
(210) 390-1795
Entity
Organization
Contact information
Practice address
327 W SUNSET RD APT 1303, SAN ANTONIO, TX 78209-1703
(626) 664-4992
Mailing address
327 W SUNSET RD APT 1303, SAN ANTONIO, TX 78209-1703
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
05/21/2021
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