Healthcare Provider Details

I. General information

NPI: 1336397520
Provider Name (Legal Business Name): PATHFINDER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 W MAIN ST
JACKSONVILLE AR
72076-4214
US

IV. Provider business mailing address

2520 W MAIN ST
JACKSONVILLE AR
72076-4214
US

V. Phone/Fax

Practice location:
  • Phone: 502-982-0528
  • Fax: 501-985-1462
Mailing address:
  • Phone: 502-982-0528
  • Fax: 501-985-1462

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: MR. JAMES C GREEN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 501-982-0528