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MATTHEW HARDIN PTA
>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1619177904
Individual Registrant: MATTHEW HARDIN PTA
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
109 GOINGS RIDGE RD HARDY, AR 72542-8810 US
Tel: 870-239-1032 Fax: --
Tel: 870-239-1032 Fax: --
Contact information for business:
109 GOINGS RIDGE RD HARDY, AR 72542-8810 US
Tel: 870-239-1032 Fax: --
Tel: 870-239-1032 Fax: --
Registration Information:
NPI: 1619177904
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant | AR | 1349 |
| N | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant | MO | 2006012978 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 142525721 | AR | 05 |
