Eggebraaten, Bradley D

Eggebraaten, Bradley D is an individual health care provider with primary practice located at 200 Patewood Dr Ste C150, Greenville SC 29615-3593. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Eggebraaten, Bradley D can be contacted via phone (864) 454-0904.

Contact Information

Primary practice address
200 Patewood Dr Ste C150 Greenville SC 29615-3593
Phone: (864) 454-0904
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT5605 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5436 South Carolina

Profile Details

NPI number 1508821109
LBN Legal business name Eggebraaten, Bradley D
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Nov 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508821109 NPPES
South Carolina MEDICAID TH1774

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