Individual
MR. GARY WADE HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
402 W COLLEGE AVE, BERRYVILLE, AR 72616-3142
(870) 423-3316
(870) 423-3177
Mailing address
402 W COLLEGE AVE., SUITE B, BERRYVILLE, AR 72616-3142
(870) 423-3316
(870) 423-3177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0197288
DEPT LABOR & INDUSTRY
WA
05
—
154774721
—
AR
01
—
5Y014
BLUECROSS
AR
01
—
608639900
USDA
AR
01
—
729459559
TRICARE
AR
Enumeration date
01/20/2006
Last updated
05/03/2013
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