Individual
BRADEN SCOTT IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4593
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233156721
—
AR
Enumeration date
01/09/2019
Last updated
05/24/2019
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