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NPI Code Detail

MEDICARE: NICHOLAS HARGETT

MEDICARE:   NICHOLAS  HARGETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 4053AR

General Provider Information

NPI Number : 1598132524
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS HARGETT
Provider Business Mailing Address
First Line : 2102 W RODERWEIS RD
Second Line :
City : CABOT
State : AR
Zip : 72023-9366
Country : US
Telephone Number : 501-590-9109
Fax Number :
Provider Business Practice Location Address
First Line : 501 JACK STEPHENS DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-5551
Country : US
Telephone Number : 501-661-7955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 08/25/2015

Similar Medicare Providers

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Practice Location Address:
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Directions to “ NICHOLAS HARGETT ” Practice Location

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