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General NPI Number Information
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NPI Number | 1730419151
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Entity Type | Individual
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Provider Name | GARRETT O'NEAL STANLEY P.T., D.P.T
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Gender | Male
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 1115 FERGUSON DR
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City | BENTON
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State | AR
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Zip | 72015-3512
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Country | US
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Telephone | 501-315-0639
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Fax | 501-315-7278
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Provider Business Mailing Address
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Address Line | 5217 CHARLES CT
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City | BRYANT
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State | AR
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Zip | 72022-9254
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Country | US
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Telephone | 501-358-1723
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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 | PT3201
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License Number State | AR
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