Healthcare Provider Details

I. General information

NPI: 1134669799
Provider Name (Legal Business Name): GENUICARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 PIPER ST STE C
HOT SPRINGS AR
71901-8263
US

IV. Provider business mailing address

117 PIPER ST STE C
HOT SPRINGS AR
71901-8263
US

V. Phone/Fax

Practice location:
  • Phone: 501-463-9057
  • Fax: 866-632-2934
Mailing address:
  • Phone: 501-463-9057
  • Fax: 866-632-2934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number0000
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0000
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number0000
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK LAYTON
Title or Position: OWNER
Credential:
Phone: 501-463-9057