Provider Demographics
NPI:1891349957
Name:GOLDEN, BRIANNA BAILEY (PT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:BAILEY
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 JEROME CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-9507
Mailing Address - Country:US
Mailing Address - Phone:334-494-2742
Mailing Address - Fax:
Practice Address - Street 1:560 DEVALL DR STE 302
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-6660
Practice Address - Country:US
Practice Address - Phone:334-844-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-27
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH7459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist