Healthcare Provider Details

I. General information

NPI: 1134744196
Provider Name (Legal Business Name): HUTTO THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17391 HIGHWAY 65 S
DAMASCUS AR
72039-8913
US

IV. Provider business mailing address

17391 HIGHWAY 65 S
DAMASCUS AR
72039-8913
US

V. Phone/Fax

Practice location:
  • Phone: 501-514-4328
  • Fax:
Mailing address:
  • Phone: 501-514-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARCUS J HUTTO
Title or Position: PRESIDENT
Credential: MS, OTR/L
Phone: 501-514-4328