Healthcare Provider Details

I. General information

NPI: 1730550203
Provider Name (Legal Business Name): FARRER PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 BRADEN ST
JACKSONVILLE AR
72076-3719
US

IV. Provider business mailing address

199 LEWISBURG RD
AUSTIN AR
72007-9455
US

V. Phone/Fax

Practice location:
  • Phone: 501-771-4693
  • Fax: 501-771-4885
Mailing address:
  • Phone: 501-771-4693
  • Fax: 501-771-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. SCOTT ROPER
Title or Position: ACCOUNT MANAGER
Credential: M.B.A.
Phone: 501-771-4693