Provider Demographics
NPI:1053575571
Name:HILL, EVAN RICHARD (PT)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:RICHARD
Last Name:HILL
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 1:1101 HORSEBARN RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8237
Mailing Address - Country:US
Mailing Address - Phone:479-636-9607
Mailing Address - Fax:
Practice Address - Street 1:1101 HORSEBARN RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8237
Practice Address - Country:US
Practice Address - Phone:479-636-9607
Practice Address - Fax:479-636-9608
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT30362251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic