IndividualActive
Brandon Divan, DPT, PT
NPI 1790332807 · Physical Therapist · Belton, MO
Provider details
- NPI number
- 1790332807
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- DPT, PT
- Sex
- Male
- Sole proprietor
- No
- License
- 070.024617 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
17134 Bel Ray Pl
Belton, MO 64012-5331
Phone: (816) 318-0434
Fax: (816) 318-0437
Approximate (ZIP-level) locationGet directions
Mailing address
535 E North St Ste C
Bradley, IL 60915-1188
Additional practice locations (2)
- 517 E North StBradley, IL 60915-1258Phone: (815) 802-7503
- 341 S Main StClifton, IL 60927-7091Phone: (815) 918-5084
Registry dates
- Enumerated
- 2019-08-22
- Last updated
- 2022-10-06
- Certified
- 2022-10-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.