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General NPI Number Information
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NPI Number | 1073738126
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Entity Type | Organization
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Legal Business Name | OZARK THERAPY, INC.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 636 OLD TRACY RD
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-7482
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Country | US
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Telephone | 870-424-5747
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2236
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City | MOUNTAIN HOME
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State | AR
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Zip | 72654-2236
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Country | US
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Telephone | 870-424-5747
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTI STEELMAN
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Credential | PT
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Telephone | 870-424-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1327
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License Number State | AR
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