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General NPI Number Information
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NPI Number | 1720687379
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Entity Type | Individual
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Provider Name | BRIANNA WEST PT, DPT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 220 N RIDGEWAY DR STE A
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City | CLEBURNE
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State | TX
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Zip | 76033-4148
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Country | US
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Telephone | 817-774-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 721 ARLINGTON DR
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City | WOODWAY
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State | TX
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Zip | 76712-3201
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Country | US
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Telephone | 325-733-6537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT7247
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1336290
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License Number State | TX
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