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General NPI Number Information
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NPI Number | 1679171383
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Entity Type | Organization
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Legal Business Name | ABOVE AND BEYOND MOBILE THERAPY PLLC
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Dates
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Enumeration Date | 10/14/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 510 SPRIGGS RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72118-2336
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Country | US
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Telephone | 501-733-1483
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Fax |
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Provider Business Mailing Address
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Address Line | 510 SPRIGGS RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72118-2336
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Country | US
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Telephone | 501-733-1483
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRYSTAL RENEE EUBANKS
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Credential | OTR
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Telephone | 501-733-1483
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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