Healthcare Provider Details
I. General information
NPI: 1477831329
Provider Name (Legal Business Name): BRITTANY SEXSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/26/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2740 COLLEGE AVE
CONWAY AR
72034-6141
US
IV. Provider business mailing address
2740 COLLEGE AVE
CONWAY AR
72034-6141
US
V. Phone/Fax
- Phone: 501-329-5459
- Fax: 501-327-1738
- Phone: 501-329-5459
- Fax: 501-327-1738
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT 3402 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: