Healthcare Provider Details

I. General information

NPI: 1396552402
Provider Name (Legal Business Name): JEFF M ZIRBEL PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 HARRISON ST
BATESVILLE AR
72501-7417
US

IV. Provider business mailing address

2236 HARRISON ST
BATESVILLE AR
72501-7417
US

V. Phone/Fax

Practice location:
  • Phone: 870-847-2500
  • Fax: 866-924-9268
Mailing address:
  • Phone: 870-847-2500
  • Fax: 866-924-9268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA987
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: