Individual
LARRY B BRAZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 E BUTLER RD BLDG E2, MAULDIN, SC 29662-2172
(864) 984-0832
(678) 840-2112
Mailing address
PO BOX 369, SIMPSONVILLE, SC 29681-0369
(864) 201-4301
(678) 840-2112
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2281
SC
Other
Enumeration date
07/08/2006
Last updated
07/08/2007
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