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General NPI Number Information
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NPI Number | 1649164831
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Entity Type | Organization
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Legal Business Name | THE DELTA THERAPY GROUP, LLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1919 COUNTY ROAD 333
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City | JONESBORO
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State | AR
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Zip | 72401-0432
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Country | US
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Telephone | 501-766-9664
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 COUNTY ROAD 333
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City | JONESBORO
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State | AR
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Zip | 72401-0432
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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 | ADRIAN SPORTSMAN
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Credential | OTD
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Telephone | 361-548-2871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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