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Individual

MR. BRETT A MINTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
943 PROGRESS RD STE 2, ELLIJAY, GA 30540-8800
(706) 698-3000
Mailing address
943 PROGRESS RD STE 2, ELLIJAY, GA 30540-8800
(706) 698-3000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5239
GA
225100000X
Physical Therapist
6999
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10035561
AMERIGROUP
GA
05
3659205
TN
05
380348284A
GA
01
4092611
BCBS
TN
Enumeration date
06/13/2005
Last updated
06/11/2019
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