Individual
DR. JASON BRAVO ALISANGCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
63624
GA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
63624
GA
Other
Enumeration date
07/18/2008
Last updated
02/24/2025
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