Provider Demographics
NPI:1164501367
Name:PRELL, BRIAN E (PT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:E
Last Name:PRELL
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:117 HARMONY CROSSING
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024
Mailing Address - Country:US
Mailing Address - Phone:706-454-1811
Mailing Address - Fax:706-454-1812
Practice Address - Street 1:117 HARMONY CROSSING
Practice Address - Street 2:SUITE 4
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024
Practice Address - Country:US
Practice Address - Phone:706-454-1811
Practice Address - Fax:706-454-1812
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPT007432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5116701137Medicare UPIN