Provider Demographics
NPI:1316199540
Name:GEORGE, NANCY RENEE (MPT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:RENEE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 INDIAN OAKS TRL
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-2592
Mailing Address - Country:US
Mailing Address - Phone:479-756-4046
Mailing Address - Fax:
Practice Address - Street 1:2571 INDIAN OAKS TRL
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-2592
Practice Address - Country:US
Practice Address - Phone:479-756-4046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 27252251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics