Individual
MR. MARK DANIEL BRAYFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
48 TUNNEL RD, SUITE 203, POTTSVILLE, PA 17901-3875
(570) 624-4777
(570) 624-4778
Mailing address
48 TUNNEL RD, SUITE 203, POTTSVILLE, PA 17901-3875
(570) 624-4777
(570) 624-4778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS013357
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS013357
PA
Other
Enumeration date
07/03/2007
Last updated
10/15/2014
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