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Individual

BRIAN EDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
267 N STATE HIGHWAY 360, MANSFIELD, TX 76063-9073
(817) 778-9361
Mailing address
4672 ARDENWOOD DR, FORT WORTH, TX 76123-4054
(317) 985-4827

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
121211
TX
225X00000X
Occupational Therapist
99062900A
IN

Other

Enumeration date
07/25/2014
Last updated
09/04/2023
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