Provider Demographics
NPI:1518634930
Name:HOUSLEY, HENRY HATCHETT (DPT)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:HATCHETT
Last Name:HOUSLEY
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 190
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-0190
Mailing Address - Country:US
Mailing Address - Phone:870-448-5732
Mailing Address - Fax:870-448-2514
Practice Address - Street 1:200 W NOME
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650-7658
Practice Address - Country:US
Practice Address - Phone:870-448-5732
Practice Address - Fax:870-448-2514
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist