Braden Tewalt, PTA
Individual provider Active NPI Physical Therapy Assistant · Hope, AR
NPI 1093295271 · NPPES record last updated Aug 17, 2018
Key facts
- NPI
- 1093295271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 3958 (AR)
- Practice address
- 400 W 23Rd St
Hope, AR 71801 - Phone
- (870) 777-3448
- NPI assigned
- Aug 17, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3958 | AR | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3958 | AR | Yes |
Addresses
Primary practice location
400 W 23Rd St
Hope, AR 71801
Mailing address
800 Hempstead 36
Hope, AR 71801-9048
Other providers in Hope, AR
- Ashley Dawn Sweeden
- Greta D. Sweesy
- Stephen Lee Swender
- Carnisha Taylor
- Jamie Taylor
- Texarkana Kidney Disease & Hypertension Center, Inc
- The Clinic for Children, Youth and Young Adults
- Eatrice Thomas
- Tennelle O Thomas
- Devonna Tillman
All providers in Hope, AR · Physical Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.