| Coulter Physical Therapy, Inc. | |
|
115 Skyline Dr, Suite A, Russellville, AR 72802-3310 | |
| (479) 967-5155 | |
| (479) 967-5141 |
| Full Name | Coulter Physical Therapy, Inc. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 115 Skyline Dr, Russellville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649261942 | NPI | - | NPPES |
| 5C407 | Other | AR | BLUE CROSS PROVIDER NUMBE |
| 117394742 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Seth Baker Coulter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003895343 PECOS PAC ID: 7911817531 Enrollment ID: I20230119000092 |
| Provider Name | Brenda Elaine Minks |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770715872 PECOS PAC ID: 3476924333 Enrollment ID: I20230201000755 |
| Provider Name | Emily Wynne Parr Walker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588192942 PECOS PAC ID: 4385915776 Enrollment ID: I20230322003130 |
| Provider Name | Mikel Thacker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770197311 PECOS PAC ID: 1052759834 Enrollment ID: I20240329002738 |
| Mailing Address | Practice Location Address |
|---|---|
| Coulter Physical Therapy, Inc. 115 Skyline Dr, Suite A, Russellville, AR 72802-3310 Ph: (479) 967-5155 | Coulter Physical Therapy, Inc. 115 Skyline Dr, Suite A, Russellville, AR 72802-3310 Ph: (479) 967-5155 |
Seth B. Coulter, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 115 Skyline Dr, Suite A, Russellville, AR 72802 Phone: 479-967-5155 Fax: 479-967-5141 | |
Ms. Brandi Nicole Koch, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1301 Russell Rd, Russellville, AR 72802 Phone: 479-967-2316 Fax: 479-967-3639 | |
Jacqueline Miller, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 E 3rd St, Russellville, AR 72801 Phone: 479-968-1198 Fax: 479-967-1178 | |
Nicholas Paul Lensing, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 N Sidney Ave, Russellville, AR 72801 Phone: 479-890-5494 Fax: 479-967-0069 | |
Mr. Jerry Wayne Manning, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3016 W Main St Ste 200, Russellville, AR 72801 Phone: 479-967-9657 Fax: 479-967-9658 | |
Kimberly D Mcdougal, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 Reasoner Ln, Russellville, AR 72802 Phone: 479-970-2175 Fax: 479-964-2126 | |
Allison Young, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 500 E 3rd St, Russellville, AR 72801 Phone: 479-968-1198 |