Basic Information
| Provider Information | |||||||||
| NPI: | 1467882084 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUERGLER | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | HADLEY | ||||||||
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| Credential: | DPT | ||||||||
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| OtherLastName: | HADLEY | ||||||||
| OtherFirstName: | LAURA | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1800 SE MOBERLY LN | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727127017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797156330 | ||||||||
| FaxNumber: | 4792685144 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 SE MOBERLY LN | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727127017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797156330 | ||||||||
| FaxNumber: | 4792685144 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2013 | ||||||||
| LastUpdateDate: | 03/05/2019 | ||||||||
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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 | 037558 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT3790 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.