Provider Demographics
NPI:1558829002
Name:SWINDLE, KRISTY (OTD/OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:SWINDLE
Suffix:
Gender:F
Credentials:OTD/OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TRICE LN
Mailing Address - Street 2:
Mailing Address - City:COTTON PLANT
Mailing Address - State:AR
Mailing Address - Zip Code:72036-9634
Mailing Address - Country:US
Mailing Address - Phone:870-394-6311
Mailing Address - Fax:870-208-8384
Practice Address - Street 1:3998 HIGHWAY 1 N
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-7637
Practice Address - Country:US
Practice Address - Phone:870-633-1737
Practice Address - Fax:870-633-1738
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3274225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist