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Individual

MR. BRALYN BENNETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5046 HIGHWAY 17 BYP S STE 200, MYRTLE BEACH, SC 29588-4503
(843) 839-3501
Mailing address
8170 ROURK ST STE 100, MYRTLE BEACH, SC 29572-4127
(843) 449-0453

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
3837
SC
363A00000X
Physician Assistant
3837
SC

Other

Enumeration date
07/29/2021
Last updated
05/08/2024
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