Brandon Scott Hale, MSOT

Individual provider Active NPI Occupational Therapist · Blountville, TN

NPI 1811272503 · NPPES record last updated Oct 13, 2011

Key facts

NPI
1811272503
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
4323 (TN)
Practice address
117 Millard LN
Blountville, TN 37617-5450
Phone
(276) 393-5047
NPI assigned
Oct 13, 2011
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
4323TNMDOccupational Therapist
0119005374VAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4323 TN Yes
Occupational Therapist 225X00000X 0119005374 VA

Addresses

Primary practice location

117 Millard LN
Blountville, TN 37617-5450

Mailing address

117 Millard LN
Blountville, TN 37617-5450
Phone (276) 393-5047

Other providers in Blountville, TN

All providers in Blountville, TN · Occupational Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.