Healthcare Provider Details

I. General information

NPI: 1629231006
Provider Name (Legal Business Name): ARTHUR P MENARD LPTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 ARD FIELD RD
JAY FL
32565-9369
US

IV. Provider business mailing address

2030 ARD FIELD RD
JAY FL
32565-9369
US

V. Phone/Fax

Practice location:
  • Phone: 573-253-3933
  • Fax:
Mailing address:
  • Phone: 573-253-3933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2009003414
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number32263
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: