Provider Demographics
NPI:1568744522
Name:BOX, BRITNEY LEIGH (OTR)
Entity Type:Individual
Prefix:MRS
First Name:BRITNEY
Middle Name:LEIGH
Last Name:BOX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 BAYOU COVE CIR
Mailing Address - Street 2:
Mailing Address - City:MC GEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654-1517
Mailing Address - Country:US
Mailing Address - Phone:870-367-4333
Mailing Address - Fax:870-367-4334
Practice Address - Street 1:178 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-367-4333
Practice Address - Fax:870-367-4334
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2460225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR2460OtherOCCUPATION THERAPY LICENSE NUMBER