Healthcare Provider Details

I. General information

NPI: 1609391838
Provider Name (Legal Business Name): TODD HOBSON AT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 FAIRWAY AVE
NORTH LITTLE ROCK AR
72116-8009
US

IV. Provider business mailing address

4801 FAIRWAY AVE
NORTH LITTLE ROCK AR
72116-8009
US

V. Phone/Fax

Practice location:
  • Phone: 501-758-1300
  • Fax: 501-758-1316
Mailing address:
  • Phone: 501-758-1300
  • Fax: 501-758-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4323
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: