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NPI Code Detail

MEDICARE: MAKENZIE FAITH BRADFORD OT

MEDICARE: MAKENZIE FAITH BRADFORD OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistAR

General Provider Information

NPI Number : 1437749710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKENZIE FAITH BRADFORD OT
Provider Business Mailing Address
First Line : 3317 N WIMBERLY DR FL 2
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4056
Country : US
Telephone Number : 479-587-3117
Fax Number : 479-587-3185
Provider Business Practice Location Address
First Line : 3317 N WIMBERLY DR FL 2
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4056
Country : US
Telephone Number : 479-587-3117
Fax Number : 479-587-3185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2021
Last Update Date : 03/24/2026

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Directions to “ MAKENZIE FAITH BRADFORD OT” Practice Location

Language Start Address Practice Location
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