Provider Demographics
NPI:1891847810
Name:BRIDGES, HANNAH (DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 WILLOW CREEK DR
Mailing Address - Street 2:STE 105
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-8707
Mailing Address - Country:US
Mailing Address - Phone:501-908-2679
Mailing Address - Fax:
Practice Address - Street 1:2740 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-9310
Practice Address - Country:US
Practice Address - Phone:501-329-5459
Practice Address - Fax:501-325-1378
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT27602251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR156524721Medicaid
AR156524721Medicaid