Healthcare Provider Details

I. General information

NPI: 1760563712
Provider Name (Legal Business Name): JOAN E SALLINGS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 I630 EXIT 7 BAPTIST HEALTH REHABILITATION INSTITUTE
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

3315 RIDGE ROAD
NORTH LITTLE ROCK AR
72116
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-7598
  • Fax: 501-202-7141
Mailing address:
  • Phone: 501-538-8230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA1394
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: