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General NPI Number Information
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NPI Number | 1720387145
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Entity Type | Organization
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Legal Business Name | GAYLA LIKE PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 03/24/2011
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 311 SFC 1003
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City | COLT
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State | AR
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Zip | 72326-8516
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Country | US
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Telephone | 870-633-4443
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Fax | 870-633-0647
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Provider Business Mailing Address
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Address Line | 311 SFC 1003
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City | COLT
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State | AR
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Zip | 72326-8516
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Country | US
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Telephone | 870-633-4443
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Fax | 870-633-0647
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. GAYLA DEANNA LIKE
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Credential | PT
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Telephone | 870-633-4443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP#2616
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2967
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License Number State | AR
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