Healthcare Provider Details

I. General information

NPI: 1679939359
Provider Name (Legal Business Name): BRITTANY NICOLE THOMAS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY NICOLE HIGGINS DPT

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 W. CHESTNUT ST.
ROGERS AR
72756
US

IV. Provider business mailing address

3625 W. CHESTNUT ST.
ROGERS AR
72756
US

V. Phone/Fax

Practice location:
  • Phone: 479-246-0101
  • Fax: 479-246-0606
Mailing address:
  • Phone: 479-246-0101
  • Fax: 479-246-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4088
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-4088
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: