Healthcare Provider Details

I. General information

NPI: 1912339771
Provider Name (Legal Business Name): MOUNT CARMEL PHYSICAL THERAPY CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 S. WALMART DRIVE
HARRISON AR
72601-1984
US

IV. Provider business mailing address

197 S. WALMART DRIVE
HARRISON AR
72601-1984
US

V. Phone/Fax

Practice location:
  • Phone: 870-204-6070
  • Fax: 870-204-6296
Mailing address:
  • Phone: 870-204-6070
  • Fax: 870-204-6296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. REMEDIOS MAGTOTO ADAMOS
Title or Position: OCCUPATIONAL THERAPY STAFF
Credential: OTR/L
Phone: 870-715-2705