Provider Demographics
NPI:1033474556
Name:BRINKLEY, KERRI J (PT)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:J
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-9694
Mailing Address - Country:US
Mailing Address - Phone:501-499-3686
Mailing Address - Fax:
Practice Address - Street 1:1065 CLAYTON ST STE 9
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4335
Practice Address - Country:US
Practice Address - Phone:501-328-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist