Provider Demographics
NPI:1659463586
Name:CARDIN, RHONDA ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ANN
Last Name:CARDIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 GRIST MILL RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-6794
Mailing Address - Country:US
Mailing Address - Phone:870-863-3691
Mailing Address - Fax:
Practice Address - Street 1:203 W. GROVE ST.
Practice Address - Street 2:GROVE STREET PT CLINIC
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4646
Practice Address - Country:US
Practice Address - Phone:870-862-4042
Practice Address - Fax:870-864-0218
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T497OtherABCBS PROVIDER NUMBER