NPI 1104033133

Brent Alan Willard, LPTA

Practitioner Physical Therapy Assistant Winston Salem, NC

Practice location

Address: 901 Bethesda Rd, Winston Salem, NC 27103-3015
Phone: (336) 768-2211
Mailing address: 5133 River Chase Rdg, Winston Salem, NC 27104-4470

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 876 (NC)

Other Physical Therapy Assistant providers in North Carolina →

Registry record

NPI: 1104033133
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 May 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.