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NPI Code Detail

MEDICARE: MATTHEW BRYAN THARP DPT

MEDICARE: MATTHEW BRYAN THARP DPT
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 TherapistPT 3723AR

General Provider Information

NPI Number : 1619309358
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW BRYAN THARP DPT
Provider Business Mailing Address
First Line : 821 E PARK ST
Second Line :
City : CARLISLE
State : AR
Zip : 72024-9024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 821 E PARK ST
Second Line :
City : CARLISLE
State : AR
Zip : 72024-9024
Country : US
Telephone Number : 870-552-7110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2013
Last Update Date : 08/05/2013

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Directions to “ MATTHEW BRYAN THARP DPT” Practice Location

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