Provider Demographics
NPI:1780239293
Name:JAMES, ARREL M (L - PTA)
Entity type:Individual
Prefix:
First Name:ARREL
Middle Name:M
Last Name:JAMES
Suffix:
Gender:M
Credentials:L - PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 HUBNER RD
Mailing Address - Street 2:
Mailing Address - City:FOR RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66441
Mailing Address - Country:US
Mailing Address - Phone:307-871-7532
Mailing Address - Fax:
Practice Address - Street 1:650 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4030
Practice Address - Country:US
Practice Address - Phone:307-871-7532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-03333225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS14-03333OtherBOARD OF PHYSICAL THERAPY