Individual
BREANN FAYE FOX
Active
Individual
BREANN FAYE FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10524
AZ
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-5245
STATE LICENSE
ID
Enumeration date
09/11/2013
Last updated
03/17/2018
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