Doctor Name: | BOBBY RAPERT |
NPI Number: | 1558715243 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PTA |
License Number: | PTA 4059 |
Business Practice Address: | 31 Choctaw Trce Cherokee Village, AR - 725292702 |
Business Phone Number: | 8708564325 |
Business Fax Number: | 8708564327 |
Mailing Address: | 105 Lenford Dr, BONO |
State: | AR |
Postal Code: | 724168527 |
Phone Number: | 5014544736 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2016 |
NPI Last Update Date: | 04/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PTA 4059 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |