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General NPI Number Information
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NPI Number | 1497457527
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC MANUAL THERAPY INSTRUCTION LTD
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 930 WINGATE ST BLDG SUITEE
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City | CONWAY
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State | AR
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Zip | 72034-4856
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Country | US
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Telephone | 501-366-0714
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Fax |
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Provider Business Mailing Address
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Address Line | 930 WINGATE ST BLDG SUITEE
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City | CONWAY
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State | AR
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Zip | 72034-4856
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN FORBUSH
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Credential |
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Telephone | 501-366-0714
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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 |
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License Number State |
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