Healthcare Provider Details

I. General information

NPI: 1609249655
Provider Name (Legal Business Name): PIPER ADAMS P.T.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SCHOOL DR
MELBOURNE AR
72556-8620
US

IV. Provider business mailing address

330 W AR 58 HWY
MELBOURNE AR
72556-7036
US

V. Phone/Fax

Practice location:
  • Phone: 870-916-2269
  • Fax: 870-277-0896
Mailing address:
  • Phone: 501-412-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA1754
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: