Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon Wayne Divan, DPT, PT

Individual provider Physical Therapist · NPI 1790332807

Brandon Wayne Divan, DPT, PT is a Physical Therapist in Belton, Missouri. Works from 3 locations. Licensed in Illinois and Missouri.

Licensed in
IL, MO
In the registry since
2019
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

17134 Bel Ray Pl
Belton, MO 64012-5331
Phone: (816) 318-0434
Fax: (816) 318-0437
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 517 E North St, Bradley, IL 60915-1258 — (815) 802-7503
  • 341 S Main St, Clifton, IL 60927-7091 — (815) 918-5084

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2022039968 (MO)
Physical Therapist Taxonomy 225100000X · Licence 070.024617 (IL)

Record details

NPI number1790332807
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT , PT
Sole proprietorNo
NPI enumeratedAugust 22, 2019
Last updated in NPPESOctober 6, 2022
Certification dateOctober 6, 2022
Mailing address535 E North St Ste C, Bradley, IL 60915-1188

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