Healthcare Provider Details

I. General information

NPI: 1326438912
Provider Name (Legal Business Name): GGT THERAPY SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 AUSTIN DR
HARRISON AR
72601-8389
US

IV. Provider business mailing address

3131 AUSTIN DR
HARRISON AR
72601-8389
US

V. Phone/Fax

Practice location:
  • Phone: 870-704-9677
  • Fax:
Mailing address:
  • Phone: 870-704-9677
  • 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: GRACE TUAZON
Title or Position: OWNER
Credential: RPT
Phone: 870-704-9677