Healthcare Provider Details
I. General information
NPI: 1811344245
Provider Name (Legal Business Name): STEVEN GEBHARDT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/16/2016
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10815 COLONEL GLENN RD STE 500
LITTLE ROCK AR
72204-8041
US
IV. Provider business mailing address
4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US
V. Phone/Fax
- Phone: 501-406-9201
- Fax: 501-320-7813
- Phone: 501-686-8000
- Fax: 501-526-5148
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT4287 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: