Provider Demographics
NPI:1053746412
Name:SPRATT, BRIANNA LEIGH (MS, ATC)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:LEIGH
Last Name:SPRATT
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:MISS
Other - First Name:BRIANNA
Other - Middle Name:LEIGH
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:223 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:WV
Mailing Address - Zip Code:26426-1227
Mailing Address - Country:US
Mailing Address - Phone:304-326-1385
Mailing Address - Fax:
Practice Address - Street 1:223 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:WV
Practice Address - Zip Code:26426-1227
Practice Address - Country:US
Practice Address - Phone:304-326-1385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAT0014982255A2300X
PART0046172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer