Provider Demographics
NPI:1235316860
Name:BRAGG, DAVID (PT, OCS, FAAOMPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BRAGG
Suffix:
Gender:M
Credentials:PT, OCS, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 FOUNDERS POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-0706
Mailing Address - Country:US
Mailing Address - Phone:615-659-7135
Mailing Address - Fax:
Practice Address - Street 1:1616 WESTGATE CIR STE 209
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8019
Practice Address - Country:US
Practice Address - Phone:615-659-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12568225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist