Individual
JACQUELINE DIANE BRAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 RENEGAR WAY, SAINT SIMONS ISLAND, GA 31522-8840
(912) 219-2029
Mailing address
111 RENEGAR WAY, SAINT SIMONS ISLAND, GA 31522-8840
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6547
SC
225100000X
Physical Therapist
Primary
PT011520
GA
Other
Enumeration date
06/08/2013
Last updated
03/05/2015
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