| Doctor Name: | KENTON WAYNE CHARLES |
| NPI Number: | 1447331400 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT2853 |
| Business Practice Address: | 710 Marion Street Suite 102 Searcy, AR - 72143 |
| Business Phone Number: | 5012682250 |
| Business Fax Number: | 5012682577 |
| Mailing Address: | 24 Eve Lane, CONWAY |
| State: | AR |
| Postal Code: | 72034 |
| Phone Number: | 5017337113 |
| Fax Number: | 5012682577 |
| NPI Enumeration Date: | 10/18/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT2853 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |