Healthcare Provider Details

I. General information

NPI: 1134277320
Provider Name (Legal Business Name): PEDIATRICS PLUS THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 COLLEGE AVE
CONWAY AR
72034-6141
US

IV. Provider business mailing address

1000 SWN DRIVE SUITE 101
CONWAY AR
72032-7836
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-5459
  • Fax: 501-327-1738
Mailing address:
  • Phone: 501-328-3274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA DENTON
Title or Position: OWNER
Credential: MSPT
Phone: 501-329-5459