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General NPI Number Information
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NPI Number | 1326595687
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Entity Type | Organization
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Legal Business Name | G&E THERAPY PROVIDERS INC
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Dates
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Enumeration Date | 09/04/2016
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Last Update Date | 09/04/2016
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Provider Practice Location Address
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Address Line | 1218 STONE ST SUITE 205
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City | JONESBORO
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State | AR
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Zip | 72401-4528
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Country | US
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Telephone | 870-277-2422
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Fax | 865-268-2982
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Provider Business Mailing Address
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Address Line | 2124 SHOSHONI DR
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City | JONESBORO
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State | AR
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Zip | 72401-6041
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Country | US
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Telephone | 870-277-2422
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Fax | 865-268-2982
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREG HARDIN
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Credential |
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Telephone | 870-277-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2251-C
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License Number State | AR
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