Healthcare Provider Details

I. General information

NPI: 1871049262
Provider Name (Legal Business Name): ARLETTE MICHALAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 08/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 HIGHWAY 62 E STE 10
MOUNTAIN HOME AR
72653-3200
US

IV. Provider business mailing address

860 HIGHWAY 62 E STE 10
MOUNTAIN HOME AR
72653-3200
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-2224
  • Fax: 870-424-2049
Mailing address:
  • Phone: 870-424-2224
  • Fax: 870-424-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA1843
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: