Provider Demographics
NPI:1174090625
Name:MOFFITT, MARCI (PT)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:
Last Name:MOFFITT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-4530
Mailing Address - Country:US
Mailing Address - Phone:870-307-8863
Mailing Address - Fax:
Practice Address - Street 1:1500 S CARAWAY RD STE B
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5308
Practice Address - Country:US
Practice Address - Phone:870-530-9007
Practice Address - Fax:870-698-8059
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4064225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist