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General NPI Number Information
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NPI Number | 1750940946
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Entity Type | Individual
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Provider Name | KIM C HARGIS PT
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Gender | Male
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 404 LLAMA DR
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City | SEARCY
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State | AR
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Zip | 72143-4785
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Country | US
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Telephone | 501-268-2292
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Fax |
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Provider Business Mailing Address
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Address Line | 226 BRADLEY ROAD 252
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City | WILMAR
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State | AR
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Zip | 71675-9055
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Country | US
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Telephone | 870-723-3022
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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 | PT3114
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License Number State | AR
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