Provider Demographics
NPI:1730329608
Name:JOHNSON VAN ZANDT, KAREN ANN (PTA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:JOHNSON VAN ZANDT
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 1:129 ALASTON PT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6648
Mailing Address - Country:US
Mailing Address - Phone:501-525-1963
Mailing Address - Fax:
Practice Address - Street 1:1910 ALBERT PIKE RD
Practice Address - Street 2:SUITES G AND H
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4011
Practice Address - Country:US
Practice Address - Phone:501-623-8520
Practice Address - Fax:501-623-8237
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1742225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant