Healthcare Provider Details

I. General information

NPI: 1639700297
Provider Name (Legal Business Name): BRIONNA ALLEN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 WORLDREACH DR
FORT MILL SC
29707-6571
US

IV. Provider business mailing address

1429 BRYANT ST STE A
CHARLOTTE NC
28208-5201
US

V. Phone/Fax

Practice location:
  • Phone: 803-548-0132
  • Fax:
Mailing address:
  • Phone: 704-919-0867
  • Fax: 704-817-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13530
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: