JUSTINA LENA JACQUELINE BRANTLEY

TAMPA, FL
NPI1528719168
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA9118933)
Enumeration Date2022-01-14
Last Update Date2025-09-30
Business Address
JUSTINA LENA JACQUELINE BRANTLEY
12902 USF MAGNOLIA DR
TAMPA, FL 33612-9416
Phone number: 813-745-4673
Mailing Address
JUSTINA LENA JACQUELINE BRANTLEY
PO BOX 198441
ATLANTA, GA 30384-8441
Phone number: 813-745-4673
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