Provider Demographics
NPI:1083964068
Name:WADSWORTH, ARNOT Q IV (PT)
Entity Type:Individual
Prefix:
First Name:ARNOT
Middle Name:Q
Last Name:WADSWORTH
Suffix:IV
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6747 SW LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7431
Mailing Address - Country:US
Mailing Address - Phone:772-215-3557
Mailing Address - Fax:
Practice Address - Street 1:3360 BURNS RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4323
Practice Address - Country:US
Practice Address - Phone:561-776-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist