=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649220807
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPTP, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2006
-----------------------------------------------------
Last Update Date | 06/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 119 WEST H AVENUE
-----------------------------------------------------
City | NORTH LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-772-3224
-----------------------------------------------------
Fax | 501-771-7648
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 119 WEST H AVENUE
-----------------------------------------------------
City | NORTH LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-772-3224
-----------------------------------------------------
Fax | 501-771-7648
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PT OWNER
-----------------------------------------------------
Name | MR. TROY WAYNE ALBERSON
-----------------------------------------------------
Credential | MSPT CLT LANA
-----------------------------------------------------
Telephone | 501-772-3224
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 0000000700
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------