Healthcare Provider Details

I. General information

NPI: 1376551325
Provider Name (Legal Business Name): ESB REHAB SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 S CARAWAY RD SUITE B2
JONESBORO AR
72401-7304
US

IV. Provider business mailing address

2701 S CARAWAY RD SUITE B2
JONESBORO AR
72401-7304
US

V. Phone/Fax

Practice location:
  • Phone: 870-933-2055
  • Fax: 870-910-0245
Mailing address:
  • Phone: 870-933-2055
  • Fax: 870-910-0245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT1409
License Number StateAR

VIII. Authorized Official

Name: ERICSON SARIEGO BACSA
Title or Position: PHYSICAL THERAPIST/ OWNER
Credential: P.T.
Phone: 870-933-2055