Individual
BREANNE PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2630 E 7TH ST STE 206, CHARLOTTE, NC 28204-4319
(704) 333-1052
(704) 333-1054
Mailing address
2630 E 7TH ST STE 206, CHARLOTTE, NC 28204-4319
(704) 333-1052
(704) 333-1054
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P15014
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9614
PHYSICAL THERAPY LICENSE
SC
01
—
P15014
STATE LICENSE
NC
Enumeration date
02/22/2011
Last updated
06/26/2025
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