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General NPI Number Information
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NPI Number | 1013556307
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 827 E MAIN ST STE B
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-2575
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Country | US
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Telephone | 870-763-8155
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Fax | 870-838-1589
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | BLYTHEVILLE
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State | AR
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Zip | 72316-0045
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Country | US
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Telephone | 870-740-6698
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Fax | 870-838-1589
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Authorized Official
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Title or Position | PRESIDENT
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Name | VALARIE OLDHAM
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Credential | PT
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Telephone | 870-740-6698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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