Provider Demographics
NPI:1730419151
Name:STANLEY, GARRETT O'NEAL (PT, DPT)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:O'NEAL
Last Name:STANLEY
Suffix:
Gender:M
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 1:5217 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-9254
Mailing Address - Country:US
Mailing Address - Phone:501-358-1723
Mailing Address - Fax:
Practice Address - Street 1:1115 FERGUSON DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3512
Practice Address - Country:US
Practice Address - Phone:501-315-0639
Practice Address - Fax:501-315-7278
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist