Provider Demographics
NPI:1558922005
Name:TRUHETT, BETHANY BROWNLEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:BROWNLEE
Last Name:TRUHETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:MORGAN
Other - Last Name:BROWNLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:105 LEXINGTON DR STE H
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6646
Mailing Address - Country:US
Mailing Address - Phone:601-910-7300
Mailing Address - Fax:601-910-7071
Practice Address - Street 1:105 LEXINGTON DR STE H
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6646
Practice Address - Country:US
Practice Address - Phone:601-910-7300
Practice Address - Fax:601-910-7071
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT5829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist