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General NPI Number Information
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NPI Number | 1972583250
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Entity Type | Individual
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Provider Name | BRANDI LEIGH HURST P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 1401 E MOULTRIE DR
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-6822
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Country | US
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Telephone | 870-762-5000
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Fax | 870-762-6688
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | MONETTE
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State | AR
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Zip | 72447-0316
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Country | US
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Telephone | 870-486-1213
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Fax | 870-762-6688
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2124
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License Number State | AR
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