Healthcare Provider Details

I. General information

NPI: 1083681530
Provider Name (Legal Business Name): JORDAN PHYSICAL THERAPY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2278 ALBERT PIKE ROAD SUITE B
HOT SPRINGS AR
71913-4157
US

IV. Provider business mailing address

PO BOX 749
BELMONT NC
28012-0749
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-0808
  • Fax: 501-767-0832
Mailing address:
  • Phone: 704-824-7800
  • Fax: 704-824-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HEATHER QUILLEN
Title or Position: BILLING MANAGER
Credential:
Phone: 704-824-7800