Provider Demographics
NPI:1174743686
Name:BRANTLEY, ERIN E (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13787 DIANNE DR
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-1256
Mailing Address - Country:US
Mailing Address - Phone:205-477-8010
Mailing Address - Fax:
Practice Address - Street 1:10341 HIGHWAY 5
Practice Address - Street 2:SUITE E
Practice Address - City:BRENT
Practice Address - State:AL
Practice Address - Zip Code:35034-3916
Practice Address - Country:US
Practice Address - Phone:205-926-6309
Practice Address - Fax:205-926-6231
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist