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NPI Code Detail

MEDICARE: ALANA K BARTLETT PT

MEDICARE: ALANA K BARTLETT PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist05009202AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105009202AOTHERINPHYSICAL THERAPIST LIC

General Provider Information

NPI Number : 1063539799
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALANA K BARTLETT PT
Provider Business Mailing Address
First Line : SOUTH ARKANSAS REHABILITATION
Second Line : 1200 OLD WARREN ROAD
City : MONTICELLO
State : AR
Zip : 71655-9723
Country : US
Telephone Number : 870-367-1548
Fax Number : 870-367-1383
Provider Business Practice Location Address
First Line : 712 W 2ND ST
Second Line :
City : LEAVENWORTH
State : IN
Zip : 47137-2264
Country : US
Telephone Number : 812-739-2292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 10/23/2015

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