Provider Demographics
NPI:1407096829
Name:COGGINS, BRIAN PAUL (PT)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PAUL
Last Name:COGGINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 BREWER DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-2410
Mailing Address - Country:US
Mailing Address - Phone:931-722-4434
Mailing Address - Fax:931-722-7569
Practice Address - Street 1:514 SOUTH HIGH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485
Practice Address - Country:US
Practice Address - Phone:931-722-2778
Practice Address - Fax:931-722-7569
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000007920225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist