Healthcare Provider Details

I. General information

NPI: 1558326348
Provider Name (Legal Business Name): AMBER ELIZABETH BATES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 LAKESHORE DRIVE
HOT SPRINGS AR
71913
US

IV. Provider business mailing address

105 NORWAY COURT
HOT SPRINGS AR
71901
US

V. Phone/Fax

Practice location:
  • Phone: 501-760-7440
  • Fax: 501-760-7442
Mailing address:
  • Phone: 501-760-7440
  • Fax: 501-760-7442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT2849
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: