Healthcare Provider Details

I. General information

NPI: 1730604372
Provider Name (Legal Business Name): BRITTANY KENT PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY KIMBRELL PT, DPT

II. Dates (important events)

Enumeration Date: 08/04/2017
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 WOODLAND HEIGHTS RD
LITTLE ROCK AR
72212-2495
US

IV. Provider business mailing address

3817 N NORDICA AVE
CHICAGO IL
60634-2379
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-3600
  • Fax:
Mailing address:
  • Phone: 773-987-6735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.023091
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: