Provider Demographics
NPI:1689024358
Name:DUHAMEL, ZACHARY (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:DUHAMEL
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 RILLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3204
Mailing Address - Country:US
Mailing Address - Phone:479-586-3294
Mailing Address - Fax:
Practice Address - Street 1:13491 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-8833
Practice Address - Country:US
Practice Address - Phone:479-586-3294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist