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MR. GUNNAR AGCAOILI PTA
>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1831563030
Individual Registrant:MR. GUNNAR AGCAOILI PTA
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
9 CHARING LN BELLA VISTA, AR 72714-6314 US
Tel: 816-716-8574 Fax: --
Tel: 816-716-8574 Fax: --
Contact information for business:
9 CHARING LN BELLA VISTA, AR 72714-6314 US
Tel: 816-716-8574 Fax: --
Tel: 816-716-8574 Fax: --
Registration Information:
NPI: 1831563030
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 | PTA 1964 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ARKANSAS BOARD OF PHYSICAL THERAPY | PTA 1964 | AR | 01 |
