Provider Demographics
NPI:1770969560
Name:CHANEY, BRIANNA M (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:M
Last Name:CHANEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:M
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3455 HIGHWAY 81
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-9138
Mailing Address - Country:US
Mailing Address - Phone:770-554-0665
Mailing Address - Fax:770-554-0685
Practice Address - Street 1:1401 CONOWINGO RD
Practice Address - Street 2:STE C
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1809
Practice Address - Country:US
Practice Address - Phone:410-420-2257
Practice Address - Fax:410-420-2267
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist