MEDICARE: EXCEPTIONAL PHYSICAL THERAPY, PLLC

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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1164764924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL PHYSICAL THERAPY, PLLC

Provider Business Mailing Address
First Line	:	1102 W SOUTH ST
Second Line	:	SUITE 9
City	:	BENTON
State	:	AR
Zip	:	72015-4053
Country	:	US
Telephone Number	:	501-778-4224
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 W SOUTH ST
Second Line	:	SUITE 9
City	:	BENTON
State	:	AR
Zip	:	72015-4053
Country	:	US
Telephone Number	:	501-778-4224
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. MARLA JO MURPHY
Credential	:	DPT
Telephone Number	:	501-249-9607

Provider Enumeration Date	:	03/20/2013
Last Update Date	:	03/20/2013

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