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General NPI Number Information
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NPI Number | 1346336245
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Entity Type | Organization
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Legal Business Name | TRI-LAKES PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/22/2013
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Provider Practice Location Address
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Address Line | 307 CARPENTER DAM ROAD BLDG. L
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8218
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Country | US
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Telephone | 501-623-6353
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Fax | 501-321-4783
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Provider Business Mailing Address
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Address Line | 307 CARPENTER DAM RD BLDG. L
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City | HOT SPRINGS
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State | AR
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Zip | 71901-8218
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Country | US
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Telephone | 501-623-6353
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Fax | 501-321-4783
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | MR. JON T HARDY
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Credential | M.P.T.
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Telephone | 501-623-6353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT 1481
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License Number State | AR
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