Provider Demographics
NPI:1831382498
Name:HARTT, WILLIAM JIM (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JIM
Last Name:HARTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3925
Mailing Address - Country:US
Mailing Address - Phone:954-202-5959
Mailing Address - Fax:954-202-5544
Practice Address - Street 1:251 W PROSPECT RD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-3925
Practice Address - Country:US
Practice Address - Phone:954-202-5959
Practice Address - Fax:954-202-5544
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 7721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist