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General NPI Number Information
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NPI Number | 1922662907
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Entity Type | Organization
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Legal Business Name | ADVANCED PEDIATRIC THERAPY
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 206 PLAZA BLVD
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City | CABOT
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State | AR
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Zip | 72023-3750
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Country | US
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Telephone | 501-259-0202
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Fax | 501-286-7958
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Provider Business Mailing Address
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Address Line | PO BOX 906
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City | CABOT
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State | AR
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Zip | 72023-0906
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Country | US
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Telephone | 501-259-0202
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Fax | 501-286-7958
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMANDA L WALKER
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Credential |
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Telephone | 501-743-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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