MEDICARE: REBECCA KATHERINE STALDER PT, 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
1	225100000X	Physical Therapist	PT5207	AR

General Provider Information

NPI Number	:	1821712621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KATHERINE STALDER PT, DPT

Provider Business Mailing Address
First Line	:	1336 CARLEY RD STE 10-12
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-5910
Country	:	US
Telephone Number	:	479-318-1660
Fax Number	:	888-333-7356

Provider Business Practice Location Address
First Line	:	1336 CARLEY RD STE 10-12
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-5910
Country	:	US
Telephone Number	:	479-318-1660
Fax Number	:	888-333-7356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2022
Last Update Date	:	06/23/2026

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