Provider Demographics
NPI:1477769412
Name:HILLBRAND, JOHN ROYAL (P T)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROYAL
Last Name:HILLBRAND
Suffix:
Gender:M
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19835 GROTH RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-8954
Mailing Address - Country:US
Mailing Address - Phone:479-422-7322
Mailing Address - Fax:
Practice Address - Street 1:19835 GROTH RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-8954
Practice Address - Country:US
Practice Address - Phone:479-422-7322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist