Organization
TIARKS THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN N TIARKS DPT (PHYSICAL THERAPIST, OWNER)
(479) 619-5514
Entity
Organization
Contact information
Practice address
2104 S WALTON BLVD, BENTONVILLE, AR 72712-6732
(479) 619-5514
Mailing address
1551 N LEXINGTON DR, CENTERTON, AR 72719-9539
(479) 619-5514
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT3288
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183881721
—
AR
Enumeration date
12/19/2017
Last updated
12/19/2017
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