Healthcare Provider Details

I. General information

NPI: 1831015734
Provider Name (Legal Business Name): HARLEY MORETON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 HIGHWAY 71 S STE 10
FORT SMITH AR
72916-9151
US

IV. Provider business mailing address

1924 9TH TER
BARLING AR
72923-1506
US

V. Phone/Fax

Practice location:
  • Phone: 479-763-7008
  • Fax: 479-763-1425
Mailing address:
  • Phone: 479-252-8965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5023
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: