MEDICARE: SRL 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
1	261QP2000X	Physical Therapy Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF3200	OTHER	AR	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5F328	OTHER	AR	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1407809080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SRL THERAPY LLC

Provider Business Mailing Address
First Line	:	11121 N RODNEY PARHAM RD STE 2A
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4158
Country	:	US
Telephone Number	:	501-225-0111
Fax Number	:	501-613-0886

Provider Business Practice Location Address
First Line	:	11121 N RODNEY PARHAM RD STE 2A
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4158
Country	:	US
Telephone Number	:	501-225-0111
Fax Number	:	501-613-0886

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST/ADMINISTRA
Name	:	SUSAN LOUKS
Credential	:	PT
Telephone Number	:	501-225-0111

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	06/04/2025

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Directions to “SRL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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