Healthcare Provider Details

I. General information

NPI: 1164345625
Provider Name (Legal Business Name): PHOENIX MOBILE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S ALBERT PIKE AVE APT 1
FORT SMITH AR
72903-3065
US

IV. Provider business mailing address

1500 S ALBERT PIKE AVE APT 1
FORT SMITH AR
72903-3065
US

V. Phone/Fax

Practice location:
  • Phone: 402-404-0036
  • Fax:
Mailing address:
  • Phone: 479-310-0760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DREW ZITEK
Title or Position: OWNER
Credential: PT, DPT
Phone: 479-310-0760