Brandun Marquise Flannigan, PTA

Individual provider Active NPI Physical Therapy Assistant · Dumas, AR

NPI 1740512896 · NPPES record last updated Jan 30, 2010

Key facts

NPI
1740512896
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2290 (AR)
Practice address
213 Adams St
Dumas, AR 71639-2312
Phone
(870) 382-5363
NPI assigned
Jan 30, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2290ARMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2290 AR Yes

Addresses

Primary practice location

213 Adams St
Dumas, AR 71639-2312

Mailing address

600 Warner St
Camden, AR 71701-4463
Phone (870) 807-1867

Other providers in Dumas, AR

All providers in Dumas, AR · Physical Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.