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General NPI Number Information
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NPI Number | 1942693965
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Entity Type | Organization
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Legal Business Name | ROBERT S MURRY PTA
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Dates
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Enumeration Date | 03/16/2015
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 122 VALLEY DR
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City | HELENA
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State | AR
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Zip | 72342-0197
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Country | US
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Telephone | 870-817-8312
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Fax |
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Provider Business Mailing Address
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Address Line | 122 VALLEY DRIVE
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City | HELENA
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State | AR
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Zip | 72342
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Country | US
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Telephone | 870-817-8313
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | MR. ROBERT S MURRY
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Credential | PTA
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Telephone | 870-817-8313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | PTA 895
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License Number State | AR
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