Provider Demographics
NPI:1659789790
Name:PEARSON, CHARLOTTE REBECCA (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:REBECCA
Last Name:PEARSON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219297
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9297
Mailing Address - Country:US
Mailing Address - Phone:417-680-0806
Mailing Address - Fax:877-766-1658
Practice Address - Street 1:7058 W SUNSET AVE STE 9A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0697
Practice Address - Country:US
Practice Address - Phone:479-751-8437
Practice Address - Fax:479-802-0575
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCP032230T225100000X
ARPT 3883225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist