Provider Demographics
NPI:1356657134
Name:WOODS, BRIGHAM REX (DPT, OCS)
Entity Type:Individual
Prefix:
First Name:BRIGHAM
Middle Name:REX
Last Name:WOODS
Suffix:
Gender:M
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E BROADWAY RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-1599
Mailing Address - Country:US
Mailing Address - Phone:480-829-0217
Mailing Address - Fax:
Practice Address - Street 1:1025 E BROADWAY RD
Practice Address - Street 2:SUITE #100
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1599
Practice Address - Country:US
Practice Address - Phone:480-829-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPT9578225100000X
CAPT37054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist