Provider Demographics
NPI:1245870625
Name:CHAPLAIN, JAMES (PTA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CHAPLAIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 ELIZABETH CIR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-2556
Mailing Address - Country:US
Mailing Address - Phone:870-503-6813
Mailing Address - Fax:
Practice Address - Street 1:326 LINDLEY LN
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-4948
Practice Address - Country:US
Practice Address - Phone:870-523-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA2326225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant