Basic Information
| Provider Information | |||||||||
| NPI: | 1700060415 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNCAN | ||||||||
| FirstName: | BETHANY | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8061 STARZ LOOP | ||||||||
| Address2: | |||||||||
| City: | FORT HOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765441793 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347142827 | ||||||||
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| Practice Location | |||||||||
| Address1: | 512 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 313134325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123684131 | ||||||||
| FaxNumber: | 9123684132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2007 | ||||||||
| LastUpdateDate: | 03/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT009143 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 1292670 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.