Provider Demographics
NPI:1851646038
Name:QUIMBO, MA HELENA GARCIA (PT)
Entity Type:Individual
Prefix:
First Name:MA HELENA
Middle Name:GARCIA
Last Name:QUIMBO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:305 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-4037
Mailing Address - Country:US
Mailing Address - Phone:479-646-5778
Mailing Address - Fax:479-770-5656
Practice Address - Street 1:125 S BLOOMINGTON ST
Practice Address - Street 2:STE A
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-9493
Practice Address - Country:US
Practice Address - Phone:479-770-5655
Practice Address - Fax:479-770-5656
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARPT1563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist