| |
135 South East Street, Mt.ida, AR 71957 | |
(870) 867-4654 | |
(870) 867-2611 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 135 South East Street, Mt.ida, Arkansas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306276217 | NPI | - | NPPES |
15614872 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
2675 Court Dr, Gastonia, NC 28054-1478 Ph: (704) 824-7800 | 135 South East Street, Mt.ida, AR 71957 Ph: (870) 867-4654 |