Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 574 | AR |
NPI | 1053587782 |
---|---|
Provider Name | Mrs. Rebecca Lynn Hartsfield |
First Address | Fort Smith, AR 72901-6932 |
Second Address | Fort Smith, AR 72901-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2008 |
Last Update Date | 02/05/2008 |