Provider Demographics
NPI:1366226391
Name:BROWN, BRIANA (DPT)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 CANAL ST STE 203
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4104
Mailing Address - Country:US
Mailing Address - Phone:334-655-7974
Mailing Address - Fax:
Practice Address - Street 1:123 CANAL ST STE 203
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4104
Practice Address - Country:US
Practice Address - Phone:334-655-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016788208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation