Healthcare Provider Details

I. General information

NPI: 1427401702
Provider Name (Legal Business Name): ADVANCED PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W HUDSON RD STE 3
ROGERS AR
72756-2181
US

IV. Provider business mailing address

1148 W RIVERDALE DR
NIXA MO
65714-8255
US

V. Phone/Fax

Practice location:
  • Phone: 479-340-1100
  • Fax: 844-317-0394
Mailing address:
  • Phone: 417-300-9965
  • Fax: 417-494-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ZACHARY BALL
Title or Position: OWNER
Credential:
Phone: 417-494-4102