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General NPI Number Information
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NPI Number | 1962926196
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Entity Type | Individual
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Provider Name | ANNEMIEKE DIONNE CORBITT PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/30/2017
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 100 WALMART DR
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City | MORRILTON
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State | AR
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Zip | 72110-4522
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Country | US
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Telephone | 501-477-2202
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Fax | 541-421-0543
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Provider Business Mailing Address
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Address Line | 2100 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2758
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Country | US
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Telephone | 479-968-2525
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Fax | 479-968-2538
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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 | PT3074
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License Number State | AR
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