Provider Demographics
NPI:1548867351
Name:PLATT, BRYSON (DPT)
Entity type:Individual
Prefix:
First Name:BRYSON
Middle Name:
Last Name:PLATT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 W 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2257
Mailing Address - Country:US
Mailing Address - Phone:317-688-7660
Mailing Address - Fax:317-580-0107
Practice Address - Street 1:1150 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2257
Practice Address - Country:US
Practice Address - Phone:317-688-7660
Practice Address - Fax:317-580-0107
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05013830A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist