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General NPI Number Information
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NPI Number | 1730530817
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Entity Type | Organization
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Legal Business Name | J5 THERAPY, INC.
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 2700 N PRICKETT RD SUITE 2B
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City | BRYANT
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State | AR
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Zip | 72022-7503
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Country | US
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Telephone | 501-213-0594
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Fax | 844-272-0941
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Provider Business Mailing Address
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Address Line | PO BOX 1419
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City | ALEXANDER
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State | AR
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Zip | 72002-3419
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Country | US
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Telephone | 501-213-0594
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Fax | 844-272-0941
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. JENNIFER MARKS
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Credential | MSCCC-SLP
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Telephone | 501-247-8366
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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 | 14079625
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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