Provider Demographics
NPI:1043241847
Name:HUDSON, BRETT (PT)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:HUDSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2322
Mailing Address - Country:US
Mailing Address - Phone:605-328-1626
Mailing Address - Fax:605-328-1640
Practice Address - Street 1:3401 W 49TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2322
Practice Address - Country:US
Practice Address - Phone:605-328-1626
Practice Address - Fax:605-328-1640
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD13612251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic