Provider Demographics
NPI:1942460787
Name:BYRD, BRITTANY NICOLE II
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICOLE
Last Name:BYRD
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:NICOLE
Other - Last Name:MCGLOTHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:674 PITMAN RD
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:AR
Mailing Address - Zip Code:72444-9319
Mailing Address - Country:US
Mailing Address - Phone:870-810-2835
Mailing Address - Fax:
Practice Address - Street 1:104 E EVERETT ST
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-3309
Practice Address - Country:US
Practice Address - Phone:870-810-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9311225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist