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NPI Code Detail

MEDICARE: REAPER THERAPY, LLC

MEDICARE: REAPER THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164712725
Entity Type Code : Organization
Provider Name (Legal Business Name) : REAPER THERAPY, LLC
Provider Business Mailing Address
First Line : 821 E PARK ST
Second Line :
City : CARLISLE
State : AR
Zip : 72024-9024
Country : US
Telephone Number : 870-552-7110
Fax Number : 870-552-7115
Provider Business Practice Location Address
First Line : 821 E PARK ST
Second Line :
City : CARLISLE
State : AR
Zip : 72024-9024
Country : US
Telephone Number : 870-552-7110
Fax Number : 870-552-7115
Authorized Official
Title or Position : LLC MEMBER
Name : MR. ALEX K COLLIER
Credential :
Telephone Number : 870-347-2568
Provider Enumeration Date : 04/15/2011
Last Update Date : 11/29/2012

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Directions to “REAPER THERAPY, LLC ” Practice Location

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