Provider Demographics
NPI:1306399282
Name:VOGL, WESTON (DPT)
Entity Type:Individual
Prefix:
First Name:WESTON
Middle Name:
Last Name:VOGL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-0297
Mailing Address - Country:US
Mailing Address - Phone:501-882-2260
Mailing Address - Fax:501-882-2369
Practice Address - Street 1:710 W DEWITT HENRY DR
Practice Address - Street 2:SUITE D
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-2102
Practice Address - Country:US
Practice Address - Phone:501-882-2260
Practice Address - Fax:501-882-2369
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist