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1366792079
JUSTIN BRAZEAL
RUSSELLVILLE, AR
NPI
1366792079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: AR OTR2546)
Enumeration Date
2012-09-11
Last Update Date
2023-01-31
Business Address
JUSTIN BRAZEAL MS, OTR/L
1301 RUSSELL RD
RUSSELLVILLE, AR 72802-4320
Phone number: 479-967-2316
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Mailing Address
JUSTIN BRAZEAL MS, OTR/L
P.O. DRAWER 2109
RUSSELLVILLE, AR 72811
Phone number: 479-967-2322
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