Provider Demographics
NPI:1942341292
Name:HATFIELD, BRIAN ANTHONY (OTR)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANTHONY
Last Name:HATFIELD
Suffix:
Gender:M
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:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:CHATTAROY
Mailing Address - State:WV
Mailing Address - Zip Code:25667-0191
Mailing Address - Country:US
Mailing Address - Phone:304-235-3339
Mailing Address - Fax:
Practice Address - Street 1:183 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3601
Practice Address - Country:US
Practice Address - Phone:561-746-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist