Provider Demographics
NPI:1205263845
Name:HEALY, CHARLES TOWNSEND (DPT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:TOWNSEND
Last Name:HEALY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5202
Mailing Address - Country:US
Mailing Address - Phone:501-225-0181
Mailing Address - Fax:501-225-0384
Practice Address - Street 1:800 FAIR PARK BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1720
Practice Address - Country:US
Practice Address - Phone:501-500-3500
Practice Address - Fax:501-777-3519
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 3743225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR319000YQCROtherMEDICARE PTAN