Individual
KATIE LEE BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
550 HARBOR COVE LN, APT. 4400L, CHARLESTON, SC 29412-3009
(513) 379-3166
Mailing address
550 HARBOR COVE LN, APT. 4400L, CHARLESTON, SC 29412-3009
(513) 379-3166
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
1819
SC
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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