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NPI Code Detail

MEDICARE: STEPHEN ALAN CRITES PT

MEDICARE: STEPHEN ALAN CRITES 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 TherapistPT450AR

General Provider Information

NPI Number : 1316066012
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN ALAN CRITES PT
Provider Business Mailing Address
First Line : 307 RECTOR HEIGHTS DR
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-2832
Country : US
Telephone Number : 501-623-2456
Fax Number :
Provider Business Practice Location Address
First Line : 300 PROSPECT AVE
Second Line : LEVI HOSPITAL
City : HOT SPRINGS
State : AR
Zip : 71901-4003
Country : US
Telephone Number : 501-622-3334
Fax Number : 501-622-3331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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