Organization · NPI-2

Braco Medical Services LLC

Physician Assistant · Waycross, GA

NPI number1124823570
StatusActive
Last updated in NPPESFeb 18, 2025

Details

NPI
1124823570
Entity type
Organization (NPI-2)
Legal business name
Braco Medical Services LLC
Organization subpart
No
Enumeration date
Feb 18, 2025
Certification date
Feb 18, 2025
Last updated
Feb 18, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant––Yes
207Q00000X Family Medicine––

Other names

  • Vitality Health And Wellness (Doing Business As)

Practice location

700 Riverside Ave
Waycross, GA 31501-5358

Phone 912-490-8546 · Fax 877-221-0052

Mailing address

700 Riverside Ave
Waycross, GA 31501-5358

Authorized official

Amanda Smith
PA-C, Owner
9124908546

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Physician Assistant providers in Waycross, GA