Provider Demographics
NPI:1417569328
Name:BATTERTON, BRANDYN HAROLD RAY (DPT)
Entity Type:Individual
Prefix:
First Name:BRANDYN
Middle Name:HAROLD RAY
Last Name:BATTERTON
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 1:1441 HIGHWAY 62 412
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9497
Mailing Address - Country:US
Mailing Address - Phone:870-955-1020
Mailing Address - Fax:870-277-0896
Practice Address - Street 1:1441 HIGHWAY 62 412
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:AR
Practice Address - Zip Code:72542-9497
Practice Address - Country:US
Practice Address - Phone:870-955-1020
Practice Address - Fax:870-277-0896
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist