Provider Demographics
NPI:1225892151
Name:HUNT, NATHAN BLAKE (DPT)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:BLAKE
Last Name:HUNT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HYLINE DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-7807
Mailing Address - Country:US
Mailing Address - Phone:817-312-9624
Mailing Address - Fax:
Practice Address - Street 1:1020 QUEENSGATE DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9123
Practice Address - Country:US
Practice Address - Phone:509-578-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist