Healthcare Provider Details
I. General information
NPI: 1730735648
Provider Name (Legal Business Name): CAROLINE ASHTON FRUEHAUF-SAUNIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/15/2019
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
916 GOBLIN DR
HARRISON AR
72601-8885
US
IV. Provider business mailing address
PO BOX 144
SAINT JOE AR
72675-0144
US
V. Phone/Fax
- Phone: 870-654-3869
- Fax: 870-505-2016
- Phone: 870-688-9294
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225200000X |
| Taxonomy | Physical Therapy Assistant |
| License Number | 4451 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: