Healthcare Provider Details
I. General information
NPI: 1134596380
Provider Name (Legal Business Name): COMMON SENSE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
266 COUNTY ROAD 3027
EUREKA SPRINGS AR
72632-9721
US
IV. Provider business mailing address
266 COUNTY ROAD 3027
EUREKA SPRINGS AR
72632-9721
US
V. Phone/Fax
- Phone: 870-416-1173
- Fax:
- Phone: 870-416-1173
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 4012 |
| License Number State | AR |
VIII. Authorized Official
Name: MS.
JOANNE
GOULCH
Title or Position: OWNER/OPERATOR
Credential: PT
Phone: 479-253-1815