Individual
RONALD EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
77 W FOREST AVE, 301, FLAGSTAFF, AZ 86001-1479
(928) 214-2836
(928) 214-2837
Mailing address
657 E COTTONWOOD ST, STE 3D, COTTONWOOD, AZ 86326-4407
(928) 214-2836
(928) 214-2837
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5294
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
5294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825458
—
AZ
Enumeration date
07/18/2008
Last updated
03/27/2021
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