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General NPI Number Information
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NPI Number | 1194892406
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY CENTER OF SOUTH ARKANSAS INC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 N NEWTON AVE
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City | EL DORADO
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State | AR
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Zip | 71730-5421
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Country | US
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Telephone | 870-863-5100
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Fax | 870-863-5102
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Provider Business Mailing Address
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Address Line | 215 N NEWTON AVE
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City | EL DORADO
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State | AR
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Zip | 71730-5421
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Country | US
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Telephone | 870-863-5100
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Fax | 870-863-5102
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. JARED CLINTON RHODES
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Credential | MS PT
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Telephone | 870-863-5100
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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 | PT2026
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License Number State | AR
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