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NPI Code Detail

MEDICARE: OZARK PHYSICAL THERAPY, LLP

MEDICARE: OZARK PHYSICAL THERAPY, LLP
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
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1146356OTHERMOBLUE CROSS BLUE SHIELD
24630980001OTHERMODME NUMBER

General Provider Information

NPI Number : 1942272836
Entity Type Code : Organization
Provider Name (Legal Business Name) : OZARK PHYSICAL THERAPY, LLP
Provider Business Mailing Address
First Line : 2725 N WESTWOOD BLVD
Second Line : SUITE 17
City : POPLAR BLUFF
State : MO
Zip : 63901-2346
Country : US
Telephone Number : 573-686-5510
Fax Number : 573-686-6846
Provider Business Practice Location Address
First Line : 2725 N WESTWOOD BLVD
Second Line : SUITE 17
City : POPLAR BLUFF
State : MO
Zip : 63901-2346
Country : US
Telephone Number : 573-686-5510
Fax Number : 573-686-6846
Authorized Official
Title or Position : PARTNER
Name : AUSTIN R TINSLEY IV
Credential :
Telephone Number : 573-686-4209
Provider Enumeration Date : 02/03/2006
Last Update Date : 02/13/2017

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Directions to “OZARK PHYSICAL THERAPY, LLP ” Practice Location

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