Provider Demographics
NPI:1700060415
Name:DUNCAN, BETHANY (PT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8061 STARZ LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-1793
Mailing Address - Country:US
Mailing Address - Phone:334-714-2827
Mailing Address - Fax:
Practice Address - Street 1:512 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4325
Practice Address - Country:US
Practice Address - Phone:912-368-4131
Practice Address - Fax:912-368-4132
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009143225100000X
TX1292670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist