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Individual

MR. BRAD THOMAS WESTBROOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1500 WILSON LOOP, WARD, AR 72176
(501) 941-5630
Mailing address
105 LORENE ST, AUSTIN, AR 72007-9146
(501) 941-5005

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1175
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5W794
BLUE CROSS BLUE SHEILD
AR
Enumeration date
01/29/2007
Last updated
07/08/2007
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