=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831382498
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM JIM HARTT P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2007
-----------------------------------------------------
Last Update Date | 08/27/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 251 W PROSPECT RD
-----------------------------------------------------
City | OAKLAND PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33309-3925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-202-5959
-----------------------------------------------------
Fax | 954-202-5544
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 251 W PROSPECT RD
-----------------------------------------------------
City | OAKLAND PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33309-3925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-202-5959
-----------------------------------------------------
Fax | 954-202-5544
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | PT 7721
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------