Individual
DR. DEVERY BRIANNE HUDDLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1103 E BOXELDER RD STE U, GILLETTE, WY 82718-5582
(307) 686-8177
Mailing address
808 CLARION DR, GILLETTE, WY 82718-7581
(707) 815-6907
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2072
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT-2072
—
WY
Enumeration date
06/03/2021
Last updated
06/03/2021
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