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General NPI Number Information
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NPI Number | 1538111612
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Entity Type | Individual
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Provider Name | THOMAS ANTHONY BARTOLE P.T.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 1200 W MAIN ST
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City | JACKSONVILLE
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State | AR
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Zip | 72076-4348
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Country | US
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Telephone | 501-982-0591
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Fax | 501-982-0592
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Provider Business Mailing Address
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Address Line | 141 CASTLE HEIGHTS DR
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City | CABOT
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State | AR
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Zip | 72023-8330
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Country | US
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Telephone | 501-941-3471
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Fax | 501-982-0592
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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 | 1796
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License Number State | AR
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