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General NPI Number Information
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NPI Number | 1508085416
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Entity Type | Individual
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Provider Name | CRAIG MARTIN BRANNAN P.T.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 820 UNIVERSITY BLVD S STE 3E
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City | MOBILE
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State | AL
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Zip | 36609-7861
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Country | US
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Telephone | 251-343-0985
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Fax | 251-343-2713
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Provider Business Mailing Address
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Address Line | 10620 JEFF HAMILTON RD
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City | MOBILE
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State | AL
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Zip | 36695-8009
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Country | US
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Telephone | 251-510-0480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH3427
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License Number State | AL
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