Provider Demographics
NPI:1275798415
Name:BRYANT, ANDREA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1033 CHESTNUT HILL CIR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4607
Mailing Address - Country:US
Mailing Address - Phone:678-613-2580
Mailing Address - Fax:
Practice Address - Street 1:1033 CHESTNUT HILL CIR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4607
Practice Address - Country:US
Practice Address - Phone:678-613-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT005042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist