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NPI Code Detail

MEDICARE: DAVID SCOTT RISIUS MS PT

MEDICARE: DAVID SCOTT RISIUS MS PT
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
1225100000XPhysical TherapistPT 1774AR

General Provider Information

NPI Number : 1477802247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID SCOTT RISIUS MS PT
Provider Business Mailing Address
First Line : PO BOX 13525
Second Line :
City : MAUMELLE
State : AR
Zip : 72113-0525
Country : US
Telephone Number : 866-251-1227
Fax Number : 866-251-1267
Provider Business Practice Location Address
First Line : 1401 LABELLE DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2315
Country : US
Telephone Number : 866-251-1227
Fax Number : 501-251-1267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2012
Last Update Date : 12/15/2022

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