Individual
BETH R BRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
15476 DEDEAUX RD STE A, GULFPORT, MS 39503-2637
(228) 215-0700
Mailing address
6300 E LAKE BLVD STE 301, VANCLEAVE, MS 39565-6771
(228) 230-2663
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5132
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015077
—
MS
01
—
1033218524
GROUP NPI
MS
Enumeration date
07/19/2012
Last updated
10/22/2025
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