Basic Information
| Provider Information | |||||||||
| NPI: | 1740354935 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATWELL | ||||||||
| FirstName: | TERRY | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 PINECREST COURT | ||||||||
| Address2: | |||||||||
| City: | CONWAY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017641457 | ||||||||
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| Practice Location | |||||||||
| Address1: | 710 MARION STREET | ||||||||
| Address2: | SUITE 102 BAPTIST HEALTH | ||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012682250 | ||||||||
| FaxNumber: | 5012682577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OTR946 | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.