Healthcare Provider Details

I. General information

NPI: 1073591582
Provider Name (Legal Business Name): STEIN ANCILLARY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8520 S 36TH TER
FORT SMITH AR
72908-8880
US

IV. Provider business mailing address

8520 S 36TH TER
FORT SMITH AR
72908-8880
US

V. Phone/Fax

Practice location:
  • Phone: 479-410-1740
  • Fax: 479-410-1596
Mailing address:
  • Phone: 479-410-1740
  • Fax: 228-875-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL STEIN
Title or Position: OWNER
Credential:
Phone: 228-875-5447