| Angelia Brantleylpc | |
|
5345 Squires Manor Rd Jackson MI 49201-9721 | |
| (269) 274-1056 | |
| Not Available |
| Full Name | Angelia Brantleylpc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5345 Squires Manor Rd, Jackson, Michigan |
| Authorized Official Name and Position | Angela Marie Brantley (OWNER) |
| Authorized Official Contact | 2692741056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angelia Brantleylpc 5345 Squires Manor Rd Jackson MI 49201-9721 Ph: (269) 274-1056 | Angelia Brantleylpc 5345 Squires Manor Rd Jackson MI 49201-9721 Ph: (269) 274-1056 |
| NPI Number | 1740934157 |
|---|---|
| Provider Enumeration Date | 02/05/2022 |
| Last Update Date | 03/11/2022 |
| Certification Date | 03/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740934157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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