Healthcare Provider Details

I. General information

NPI: 1154802569
Provider Name (Legal Business Name): BRANDON ANIBLE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 WILLAMETTE ST STE 5
EUGENE OR
97405-7211
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 541-844-1728
  • Fax:
Mailing address:
  • Phone: 423-541-5846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4478
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14280812-2401
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP053492T
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP060194T
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: