Healthcare Provider Details

I. General information

NPI: 1033561584
Provider Name (Legal Business Name): LEAP THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 STONE ST STE 140
JONESBORO AR
72401-4568
US

IV. Provider business mailing address

1218 STONE ST STE 140
JONESBORO AR
72401-4568
US

V. Phone/Fax

Practice location:
  • Phone: 870-336-0220
  • Fax: 870-558-5637
Mailing address:
  • Phone: 870-530-3100
  • Fax: 870-558-5637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ANGELA CULVER
Title or Position: OWNER
Credential:
Phone: 870-530-3100