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General NPI Number Information
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NPI Number | 1104323724
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Entity Type | Organization
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Legal Business Name | UNIVERSAL THERAPY SERVICES
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 1931 N BATSFORD DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6961
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Country | US
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Telephone | 479-879-1611
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 N BATSFORD DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6961
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Country | US
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Telephone | 479-879-1611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARITY BENNETT JONES
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Credential | CCC-SLP
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Telephone | 479-879-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SP3166
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License Number State | AR
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