Provider Demographics
NPI:1164501367
Name:PRELL, BRIAN E (PT)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:E
Last Name:PRELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2230 HARPERFIELD TER
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-2512
Mailing Address - Country:US
Mailing Address - Phone:678-316-3274
Mailing Address - Fax:706-395-8759
Practice Address - Street 1:3651 MARS HILL ROAD
Practice Address - Street 2:SUITE 2900
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5985
Practice Address - Country:US
Practice Address - Phone:678-936-0273
Practice Address - Fax:706-395-8759
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
GAPT007432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5116701137Medicare UPIN