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1134255904
TED MORAN BRAXLEY
MACON, GA
NPI
1134255904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN 53898 NP)
Enumeration Date
2007-02-26
Last Update Date
2007-07-08
Business Address
Mr. TED MORAN BRAXLEY RN 053898 NP
811 HEMLOCK ST
MACON, GA 31201-2144
Phone number: 478-751-6120
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Mailing Address
Mr. TED MORAN BRAXLEY RN 053898 NP
811 HEMLOCK ST
MACON, GA 31201-2144
Phone number: 478-751-6120
Copy
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