Provider Demographics
NPI:1285917419
Name:BRATTON, ANDREW B (PT, DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:BRATTON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S 29TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-2501
Mailing Address - Country:US
Mailing Address - Phone:405-224-3100
Mailing Address - Fax:405-224-3102
Practice Address - Street 1:304 S 29TH ST
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2501
Practice Address - Country:US
Practice Address - Phone:405-224-3100
Practice Address - Fax:405-224-3102
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist