Basic Information
| Provider Information | |||||||||
| NPI: | 1316178742 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | AIMEE | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21729 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719031729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017607440 | ||||||||
| FaxNumber: | 5017607442 | ||||||||
| Practice Location | |||||||||
| Address1: | 1510 LAKESHORE DR | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017607440 | ||||||||
| FaxNumber: | 5017607442 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2009 | ||||||||
| LastUpdateDate: | 08/03/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 2779 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.