Provider Demographics
NPI:1124425780
Name:ALLBRITTON, BRANDI (ATC)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:ALLBRITTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11203 KENLEY WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8047
Mailing Address - Country:US
Mailing Address - Phone:205-453-2709
Mailing Address - Fax:
Practice Address - Street 1:5291 VALLEYDALE RD STE 113
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-7706
Practice Address - Country:US
Practice Address - Phone:205-408-4123
Practice Address - Fax:205-408-4189
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer