Provider Demographics
NPI:1750582821
Name:NALLEY, PATRICK JEFFREY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JEFFREY
Last Name:NALLEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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:501-978-2772
Mailing Address - Fax:
Practice Address - Street 1:600 S MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5202
Practice Address - Country:US
Practice Address - Phone:501-978-2772
Practice Address - Fax:501-978-2630
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 20092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPT 2009OtherPT LICENSE