Provider Demographics
NPI:1326574112
Name:ARNETT, PERRY JONATHAN (PTA)
Entity Type:Individual
Prefix:MR
First Name:PERRY
Middle Name:JONATHAN
Last Name:ARNETT
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-1416
Mailing Address - Country:US
Mailing Address - Phone:270-298-3112
Mailing Address - Fax:
Practice Address - Street 1:1939 ALMA CT
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9505
Practice Address - Country:US
Practice Address - Phone:270-836-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA00741225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant