| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BRIAN ALLEN HENRY | 1063605152 | 2023-03-12 |
Brian Allen Henry is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1063605152. Registration indicates Brian Allen Henry is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapy Assistant (Physical Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapy Assistant) (Physical Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapy Assistant) (Physical Therapy Assistant, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Brian Allen Henry LPTA |
| Practice Office Address | 13 NORTHTOWN DR SUITE 110 JACKSON, MS US |
| Practice Office Telephone | 6012069195 |
| Practice Office Fax | 6019578391 |
| Mailing Address | 13 NORTHTOWN DR SUITE 110 JACKSON, MS 392113047 US |
| Business Telephone | 6012069195 |
| Business Fax | 6019578391 |
| Code | Practice | License No State |
|---|---|---|
| 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant Physical Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | A7693R
LA |
| 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant Physical Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | CP017917A
LA |
| 225200000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant Physical Therapy Assistant Speech/Occupational/Physical Therapy/Chiropractor Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers | PTA2693
MS |