Individual
MELANIE SUE BRACEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
100 LINDSEY LN, SUITE A, KINGSLAND, GA 31548-6850
(912) 729-1333
Mailing address
100 LINDSEY LN, SUITE A, KINGSLAND, GA 31548-6850
(912) 729-1333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008069
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214563
BCBS GA
GA
05
—
274053687A
—
GA
05
—
274053687B,C,D
—
GA
Enumeration date
06/02/2006
Last updated
11/13/2008
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