Provider Demographics
NPI:1023341674
Name:BRAVIS ENTERPRISES, INC.
Entity type:Organization
Organization Name:BRAVIS ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-282-0755
Mailing Address - Street 1:200 RENAISSANCE DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-7612
Mailing Address - Country:US
Mailing Address - Phone:724-282-0755
Mailing Address - Fax:724-282-7723
Practice Address - Street 1:1801 LINCOLN WAY
Practice Address - Street 2:LYONS PROFESSIONAL BUILDING
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:75131-1724
Practice Address - Country:US
Practice Address - Phone:724-282-0755
Practice Address - Fax:724-282-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty