Healthcare Provider Details

I. General information

NPI: 1962318170
Provider Name (Legal Business Name): THE PIT PHYSICAL THERAPY AND PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 S MAIN ST
JONESBORO AR
72401-2909
US

IV. Provider business mailing address

4305 E BEKAH DR UNIT 5
JONESBORO AR
72404-7958
US

V. Phone/Fax

Practice location:
  • Phone: 870-283-1617
  • Fax:
Mailing address:
  • Phone: 870-283-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHANCE WALLS
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DPT
Phone: 870-283-1617