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General NPI Number Information
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NPI Number | 1215098462
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Entity Type | Organization
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Legal Business Name | WESTERN ARKANSAS PEDIATRIC REHAB INC.
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 1919 CHARMONT DRIVE
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City | CHARLESTON
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State | AR
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Zip | 72933-0871
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Country | US
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Telephone | 479-965-6752
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 871
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City | CHARLESTON
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State | AR
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Zip | 72933-0871
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Country | US
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Telephone | 479-965-6752
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANNA MARIE ROWLAND
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Credential | OTR
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Telephone | 479-965-2612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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