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General NPI Number Information
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NPI Number | 1578749958
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Entity Type | Individual
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Provider Name | KAREN R DUVALL PTA
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Gender | Female
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 01/15/2008
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Provider Practice Location Address
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Address Line | 1101 S ERIE AVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-6857
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Country | US
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Telephone | 479-968-1198
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Fax | 479-968-1198
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Provider Business Mailing Address
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Address Line | 266 HAPPY BEND RD
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City | ATKINS
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State | AR
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Zip | 72823-3359
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Country | US
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Telephone | 479-641-1162
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Fax | 479-968-1198
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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 | 1639
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License Number State | AR
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