Provider Demographics
NPI:1093227282
Name:BRAUNSTEIN, PEYTON KAYLEY M'LYN (ATC)
Entity Type:Individual
Prefix:MISS
First Name:PEYTON
Middle Name:KAYLEY M'LYN
Last Name:BRAUNSTEIN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:233 CHADWICK CIR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-8836
Mailing Address - Country:US
Mailing Address - Phone:478-718-4247
Mailing Address - Fax:
Practice Address - Street 1:210 E DERENNE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6736
Practice Address - Country:US
Practice Address - Phone:912-644-5321
Practice Address - Fax:912-629-3501
Is Sole Proprietor?:No
Enumeration Date:2017-10-29
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0036682255A2300X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer