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General NPI Number Information
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NPI Number | 1740025154
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Entity Type | Organization
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Legal Business Name | NATURAL STATE THERAPY, PLLC
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Dates
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Enumeration Date | 06/27/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1101 W CYPRESS ST
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City | ROGERS
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State | AR
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Zip | 72756
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Country | US
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Telephone | 479-234-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 11 WHITHORN CIR
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City | BELLA VISTA
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State | AR
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Zip | 72715-4021
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Country | US
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Telephone | 479-234-7680
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Fax | 855-297-5098
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | KEELEY COTTER
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Credential | OTD, OTR/L
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Telephone | 479-234-7680
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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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