Provider Demographics
NPI:1083167753
Name:JAMES, LARINDA (LPTA)
Entity Type:Individual
Prefix:
First Name:LARINDA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 HOELSCHER LN
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-1275
Mailing Address - Country:US
Mailing Address - Phone:870-857-0049
Mailing Address - Fax:870-857-3027
Practice Address - Street 1:1700 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:AR
Practice Address - Zip Code:72422-1903
Practice Address - Country:US
Practice Address - Phone:870-857-0049
Practice Address - Fax:870-857-3027
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA 1815225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145135721Medicaid