Healthcare Provider Details

I. General information

NPI: 1659195196
Provider Name (Legal Business Name): MARGARETTE OLOSAN PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4328 CENTRAL AVE STE E
HOT SPRINGS AR
71913-5907
US

IV. Provider business mailing address

109 TWINPINES ST
HOT SPRINGS AR
71901-7923
US

V. Phone/Fax

Practice location:
  • Phone: 501-525-5888
  • Fax: 501-525-5897
Mailing address:
  • Phone: 501-297-3988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1172
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: