Mrs Shelby Brazeal, | |
75 Highway 62 412 Ste A, Ash Flat, AR 72513-9629 | |
(870) 994-7778 | |
Not Available |
Full Name | Mrs Shelby Brazeal |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 75 Highway 62 412 Ste A, Ash Flat, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679978233 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OTR2769 (Arkansas) | Primary |
Provider Name | Spring River Home Health Agency Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1205476322 PECOS PAC ID: 5991967796 Enrollment ID: O20210120000062 |
Mailing Address | Practice Location Address |
---|---|
Mrs Shelby Brazeal, 75 Highway 62 412 Ste A, Ash Flat, AR 72513-9629 Ph: () - | Mrs Shelby Brazeal, 75 Highway 62 412 Ste A, Ash Flat, AR 72513-9629 Ph: (870) 994-7778 |
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