Provider Demographics
NPI:1699222091
Name:DOTSON, BRANDI (PT, DPT, MBA, OCS)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:DOTSON
Suffix:
Gender:F
Credentials:PT, DPT, MBA, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 GARDENWICK RD
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5668
Mailing Address - Country:US
Mailing Address - Phone:720-353-8755
Mailing Address - Fax:
Practice Address - Street 1:1812 POWDER SPRINGS RD SW STE 2101
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4384
Practice Address - Country:US
Practice Address - Phone:678-528-1704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist