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General NPI Number Information
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NPI Number | 1437413622
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Entity Type | Organization
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Legal Business Name | BEEBE PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 710 W DEWITT HENRY DR STE D
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City | BEEBE
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State | AR
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Zip | 72012-2102
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Country | US
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Telephone | 501-882-2260
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | BEEBE
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State | AR
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Zip | 72012-0297
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Country | US
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Telephone | 501-882-2260
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Fax | 501-882-2369
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Authorized Official
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Title or Position | PT/OWNER
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Name | JACOB A LANDRUM
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Credential | DPT
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Telephone | 501-882-2260
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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 | 2923
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License Number State | AR
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