Provider Demographics
NPI:1831415413
Name:AHRENTS, LOIS LEANN (PTA)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:LEANN
Last Name:AHRENTS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 JOY CAROL LOOP
Mailing Address - Street 2:
Mailing Address - City:BETHEL HEIGHTS
Mailing Address - State:AR
Mailing Address - Zip Code:72764-8161
Mailing Address - Country:US
Mailing Address - Phone:479-721-7561
Mailing Address - Fax:
Practice Address - Street 1:427 W CENTERTON BLVD
Practice Address - Street 2:
Practice Address - City:CENTERTON
Practice Address - State:AR
Practice Address - Zip Code:72719-8701
Practice Address - Country:US
Practice Address - Phone:479-795-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA1831225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant