Provider Demographics
NPI:1447942263
Name:OLIVE, BRADEN WRIGHT (DPT)
Entity type:Individual
Prefix:DR
First Name:BRADEN
Middle Name:WRIGHT
Last Name:OLIVE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:4 OFFICE PARK CIR STE 217
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2674
Mailing Address - Country:US
Mailing Address - Phone:205-263-2770
Mailing Address - Fax:205-263-0994
Practice Address - Street 1:10 MEADOWVIEW DR STE 201
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-7700
Practice Address - Country:US
Practice Address - Phone:205-332-3000
Practice Address - Fax:205-545-8358
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALPTH11370225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist