Individual
BRANDON FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
241 MAPLE ST, MADISON, TN 37115-3926
(858) 750-0719
Mailing address
241 MAPLE ST, MADISON, TN 37115-3926
(858) 750-0719
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
300705
CA
225100000X
Physical Therapist
Primary
15780
TN
225100000X
Physical Therapist
CP033489T
NH
Other
Enumeration date
10/21/2021
Last updated
08/23/2024
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