Individual
CAROLINE MALONE BRANNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3985 STEVE REYNOLDS BLVD BLDG G, NORCROSS, GA 30093-3001
(770) 622-2532
Mailing address
3642 N KIMBERLY DR, ATLANTA, GA 30340-4316
(404) 281-3058
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014934
GA
2251P0200X
Pediatric Physical Therapist
PT014934
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT014934
GEORGIA STATE BOARD OF PHYSICAL THERAPY
GA
Enumeration date
09/04/2020
Last updated
02/06/2023
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