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General NPI Number Information
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NPI Number | 1669913257
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Entity Type | Organization
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Legal Business Name | THERAPY FOR LIFE, LLC
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Dates
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Enumeration Date | 03/15/2017
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 9460 HWY 62 E
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City | FLIPPIN
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State | AR
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Zip | 72634
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Country | US
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Telephone | 870-404-7736
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 353
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City | FLIPPIN
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State | AR
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Zip | 72634-0353
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Country | US
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Telephone | 870-404-7736
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | REBECCA HICKS
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Credential |
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Telephone | 870-404-7736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR2765
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License Number State | AR
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