Provider Demographics
NPI:1679453567
Name:BECKHAM, BRADEN ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:BRADEN
Middle Name:ELIZABETH
Last Name:BECKHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 MEADOW VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1661
Mailing Address - Country:US
Mailing Address - Phone:423-797-4555
Mailing Address - Fax:423-797-4556
Practice Address - Street 1:109 MEADOW VIEW RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1661
Practice Address - Country:US
Practice Address - Phone:423-797-4555
Practice Address - Fax:423-797-4556
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist