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General NPI Number Information
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NPI Number | 1548068885
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Entity Type | Individual
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Provider Name | ANITA KAY HEAVNER PT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 134 HILLVIEW DR. SUITE 6
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City | CLINTON
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State | AR
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Zip | 72031-7203
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Country | US
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Telephone | 501-884-6884
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Fax | 501-884-6886
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Provider Business Mailing Address
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Address Line | 134 HILLVIEW DRIVE SUITE 6
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City | FAIRFIELD BAY
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State | AR
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Zip | 72088
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Country | US
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Telephone | 501-884-6884
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Fax | 501-884-6886
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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 | 797
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License Number State | AR
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