Healthcare Provider Details

I. General information

NPI: 1982478145
Provider Name (Legal Business Name): AIDA GARCIA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 W HUNTSVILLE AVE
SPRINGDALE AR
72762-2833
US

IV. Provider business mailing address

620 OAK AVE APT B
SPRINGDALE AR
72764-3354
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-7771
  • Fax:
Mailing address:
  • Phone: 479-502-2408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: