Provider Demographics
NPI:1316580152
Name:POWELL, BRIAN (ATC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:POWELL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 SAINT JOSEPH ST APT 228
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3649
Mailing Address - Country:US
Mailing Address - Phone:508-596-4690
Mailing Address - Fax:
Practice Address - Street 1:344 SAINT JOSEPH ST APT 228
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3649
Practice Address - Country:US
Practice Address - Phone:508-596-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer