Provider Demographics
NPI:1407910862
Name:SCHONEMAN, GRETA LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:LYNN
Last Name:SCHONEMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 SPRING VALLEY CV
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-3685
Mailing Address - Country:US
Mailing Address - Phone:501-307-5545
Mailing Address - Fax:501-771-7648
Practice Address - Street 1:119 W H AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8733
Practice Address - Country:US
Practice Address - Phone:501-772-3224
Practice Address - Fax:501-771-7648
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA 1856225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148718721Medicaid