| Colton Waters, DOT | |
|
2100 W Main St, Russellville, AR 72801-2758 | |
| (479) 968-2525 | |
| (479) 968-2539 |
| Full Name | Colton Waters |
|---|---|
| Gender | Male |
| Speciality | Occupational Therapist |
| Location | 2100 W Main St, Russellville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295560522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT2024-016 (Arkansas) | Primary |
| Provider Name | River Valley Therapy & Sports Medicine Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1619925732 PECOS PAC ID: 1850294018 Enrollment ID: O20040127001051 |
| Mailing Address | Practice Location Address |
|---|---|
| Colton Waters, DOT 2100 W Main St, Russellville, AR 72801-2758 Ph: (479) 968-2525 | Colton Waters, DOT 2100 W Main St, Russellville, AR 72801-2758 Ph: (479) 968-2525 |
Kamala J Mcdonald, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2100 W Main St, Russellville, AR 72801 Phone: 479-968-2525 Fax: 479-968-2538 | |
Melissa Hawkins, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Road, Russellville, AR 72801 Phone: 479-967-2322 Fax: 479-967-2876 | |
Chastity Massengale, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Road, Russellville, AR 72801 Phone: 479-967-2322 | |
Mrs. Alicia M Bost, M.S.O.T.R.L. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2315 Honeysuckle Ln, Russellville, AR 72801 Phone: 479-858-6144 Fax: 479-858-6144 | |
Mrs. Sandra Lynn Baker, MS OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Rd, Russellville, AR 72802 Phone: 479-967-2316 Fax: 479-967-3639 | |
Randi Ellen Rogers, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Road, Russellville, AR 72801 Phone: 479-967-2322 | |
Mrs. Brandi Akin, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 701 E Main St Ste 16, Russellville, AR 72801 Phone: 479-858-2216 |