Individual
KELLY BRANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 N SAN ANTONIO ST, WHITNEY, TX 76692-2148
(817) 832-5339
Mailing address
101 N SAN ANTONIO ST, WHITNEY, TX 76692-2148
(817) 832-5339
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2015327
TX
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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