Provider Demographics
NPI:1134843774
Name:VANMETER, CORTNEY ELOISE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:ELOISE
Last Name:VANMETER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:AR
Mailing Address - Zip Code:72933-9254
Mailing Address - Country:US
Mailing Address - Phone:479-970-6977
Mailing Address - Fax:479-662-4766
Practice Address - Street 1:1811 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:AR
Practice Address - Zip Code:72933-9254
Practice Address - Country:US
Practice Address - Phone:479-970-6977
Practice Address - Fax:479-662-4766
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty