Healthcare Provider Details

I. General information

NPI: 1962519389
Provider Name (Legal Business Name): WLRPT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 KANIS RD STE D4
LITTLE ROCK AR
72211-3769
US

IV. Provider business mailing address

11900 KANIS RD STE D4
LITTLE ROCK AR
72211-3769
US

V. Phone/Fax

Practice location:
  • Phone: 501-221-6009
  • Fax: 501-801-1065
Mailing address:
  • Phone: 501-221-6009
  • Fax: 501-801-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1865
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARBY H. BRIGHTON
Title or Position: OWNER/PHYSICAL THERAPIST
Credential:
Phone: 501-221-6009