| Organization Name: | KINGS RIVER PHYSICAL THERAPY INC |
| NPI Number: | 1245431964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY WADE HILL (PRESIDENT) |
| Mailing Address: | 402 W College Ave. Berryville |
| State: | AR US |
| Postal Code: | 726163142 |
| Phone Number: | 8704233316 |
| Fax Number: | 8704233177 |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 05/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT2047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |