Healthcare Provider Details

I. General information

NPI: 1497792766
Provider Name (Legal Business Name): BRANDI STEELE OTD,OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 FOX RD SUITE A
JONESBORO AR
72404-9322
US

IV. Provider business mailing address

1714 HIGH RIDGE LN
JONESBORO AR
72404-8426
US

V. Phone/Fax

Practice location:
  • Phone: 870-926-7725
  • Fax: 870-933-9293
Mailing address:
  • Phone: 870-926-7725
  • Fax: 870-933-9293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOTR1783
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: