MEDICARE: ADVANCE THERAPY

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	235Z00000X	Speech-Language Pathologist	2156	AR

Other Identifiers

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

General Provider Information

NPI Number	:	1750502225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE THERAPY

Provider Business Mailing Address
First Line	:	8544 GURLEY FARM RD
Second Line	:
City	:	BISCOE
State	:	AR
Zip	:	72017-9733
Country	:	US
Telephone Number	:	870-998-2530
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 N NEW YORK AVE
Second Line	:
City	:	BRINKLEY
State	:	AR
Zip	:	72021-2126
Country	:	US
Telephone Number	:	870-734-1155
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ALLISON GURLEY
Credential	:	M.S. CCC-SLP
Telephone Number	:	870-998-2530

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	06/16/2008

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Directions to “ADVANCE THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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