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General NPI Number Information
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NPI Number | 1124465497
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Entity Type | Individual
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Provider Name | KAREN WILLEMS-HAWKINS PTA
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Gender | Female
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 112 S FULTON ST
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City | CLARKSVILLE
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State | AR
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Zip | 72830-3612
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Country | US
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Telephone | 479-754-4060
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Fax | 479-754-4060
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Provider Business Mailing Address
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Address Line | 303 S 12TH ST
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City | SCRANTON
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State | AR
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Zip | 72863-9007
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Country | US
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Telephone | 479-438-4622
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Fax | 479-754-4060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA2733
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License Number State | AR
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