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General NPI Number Information
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NPI Number | 1871694471
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Entity Type | Individual
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Provider Name | DANIEL CHRISTOPHER COTHERN PT
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 1998 W GRAND BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5077
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Country | US
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Telephone | 866-251-1227
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Fax | 866-251-1267
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Provider Business Mailing Address
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Address Line | PO BOX 13525
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City | MAUMELLE
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State | AR
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Zip | 72113-0525
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Country | US
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Telephone | 866-251-1227
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Fax | 866-251-1267
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2286
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT 2286
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License Number State | AR
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