Healthcare Provider Details

I. General information

NPI: 1235028572
Provider Name (Legal Business Name): BRIANNA MCMILLAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 TOWN CREEK RD
AIKEN SC
29803-5841
US

IV. Provider business mailing address

181 TOWN CREEK RD
AIKEN SC
29803-5841
US

V. Phone/Fax

Practice location:
  • Phone: 803-642-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number7050
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: