| Doctor Name: | BRIANA BACON |
| NPI Number: | 1982065371 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 8053 |
| Business Practice Address: | 3634a Sunset Blvd West Columbia, SC - 29169 |
| Business Phone Number: | 8034510244 |
| Business Fax Number: | 8034510245 |
| Mailing Address: | Po Box 3408, IRMO |
| State: | SC |
| Postal Code: | 290634015 |
| Phone Number: | 8034220247 |
| Fax Number: | 8034510245 |
| NPI Enumeration Date: | 03/11/2016 |
| NPI Last Update Date: | 03/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 8053 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |