Doctor Name: | GARY WIDNER |
NPI Number: | 1518333988 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT1725 |
Business Practice Address: | 6801 Rogers Ave Fort Smith, AR - 729034067 |
Business Phone Number: | 4792745300 |
Business Fax Number: | 4792745349 |
Mailing Address: | Po Box 3528, FORT SMITH |
State: | AR |
Postal Code: | 729133528 |
Phone Number: | 4792742000 |
Fax Number: | 4792742194 |
NPI Enumeration Date: | 08/19/2015 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT1725 |
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 |