Provider Demographics
NPI:1073647137
Name:BRASHER, ELIZABETH MARILYNN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARILYNN
Last Name:BRASHER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
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Mailing Address - Street 1:1703 ROBINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5548
Mailing Address - Country:US
Mailing Address - Phone:870-236-6366
Mailing Address - Fax:870-236-6366
Practice Address - Street 1:293 GREENE ROAD 606
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-9785
Practice Address - Country:US
Practice Address - Phone:870-215-6466
Practice Address - Fax:870-236-6366
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARPTA 1489225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant