Healthcare Provider Details

I. General information

NPI: 1740297340
Provider Name (Legal Business Name): TRILOGY THERAPY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8952 MARKET ST SUITE 7B
DOVER AR
72837-9110
US

IV. Provider business mailing address

8952 MARKET ST SUITE 7B
DOVER AR
72837-9110
US

V. Phone/Fax

Practice location:
  • Phone: 479-331-3303
  • Fax: 800-661-8025
Mailing address:
  • Phone: 479-331-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DREW AUSTIN NORTHERN
Title or Position: OWNER
Credential:
Phone: 479-331-3303