Healthcare Provider Details

I. General information

NPI: 1992827042
Provider Name (Legal Business Name): NEWPORT ADVANCED PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MALCOLM AVENUE
NEWPORT AR
72112-7211
US

IV. Provider business mailing address

801 MALCOLM AVENUE
NEWPORT AR
72112-3691
US

V. Phone/Fax

Practice location:
  • Phone: 870-523-6500
  • Fax: 870-523-6508
Mailing address:
  • Phone: 870-523-6500
  • Fax: 870-523-6508

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: MRS. LORI LYNN OWENS
Title or Position: OWNER PHYSICAL THERAPIST
Credential: M.S.P.T.
Phone: 870-523-6500