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General NPI Number Information
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NPI Number | 1215172895
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Entity Type | Individual
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Provider Name | TINIKA OSBORNE PT
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Gender | Female
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 908 NW 8TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-4561
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Country | US
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Telephone | 479-273-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 17950 CLEAR WATER RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5896
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Country | US
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Telephone | 479-595-1896
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 2993
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License Number State | AR
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