Provider Demographics
NPI:1922815943
Name:MERCHANT, MARK EDWARD II (LPTA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:EDWARD
Last Name:MERCHANT
Suffix:II
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 FINANCIAL CENTRE PKWY STE 485
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3539
Mailing Address - Country:US
Mailing Address - Phone:573-300-2520
Mailing Address - Fax:
Practice Address - Street 1:10800 FINANCIAL CENTRE PKWY STE 485
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3539
Practice Address - Country:US
Practice Address - Phone:573-300-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA4746225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant