Provider Demographics
NPI:1083139083
Name:ELBON, BRE'ANNA LEIGH (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRE'ANNA
Middle Name:LEIGH
Last Name:ELBON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRE'ANNA
Other - Middle Name:LEIGH
Other - Last Name:SCHOPKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:2580 WINDY HILL RD SE STE 300
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8642
Practice Address - Country:US
Practice Address - Phone:770-916-1567
Practice Address - Fax:770-916-1785
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist