Healthcare Provider Details

I. General information

NPI: 1275200768
Provider Name (Legal Business Name): WHITLEY A CURTIS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S 2ND ST SUITE B
CABOT AR
72023-7030
US

IV. Provider business mailing address

34 OAK GROVE CIR APT 5
CABOT AR
72023-2413
US

V. Phone/Fax

Practice location:
  • Phone: 501-286-6075
  • Fax: 501-286-6175
Mailing address:
  • Phone: 870-316-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4556
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: