Healthcare Provider Details

I. General information

NPI: 1447760392
Provider Name (Legal Business Name): VTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2017
Last Update Date: 08/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 MAIN ST
VILONIA AR
72173
US

IV. Provider business mailing address

PO BOX 128
VILONIA AR
72173-0128
US

V. Phone/Fax

Practice location:
  • Phone: 501-796-3240
  • Fax: 501-796-3242
Mailing address:
  • Phone: 501-796-3240
  • Fax: 501-796-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateAR

VIII. Authorized Official

Name: THOMAS P BATES
Title or Position: OWNER
Credential: PT, MS, CERT MDT
Phone: 501-796-3240