Healthcare Provider Details

I. General information

NPI: 1639003296
Provider Name (Legal Business Name): BREANNA FUCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 LAWRENCEVILLE SUWANEE RD
SUWANEE GA
30024-8603
US

IV. Provider business mailing address

5752 PLEASANT WOODS DR
FLOWERY BRANCH GA
30542-8405
US

V. Phone/Fax

Practice location:
  • Phone: 770-574-4141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018324
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: