Organization Name: | GRAND PRAIRIE PHYSICAL THERAPY OF STUTTGART, INC. |
NPI Number: | 1497770242 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MANDY LEE FISCHER (OFFICE MANAGER) |
Mailing Address: | 2105 S Main St Stuttgart |
State: | AR US |
Postal Code: | 72160 |
Phone Number: | 8706737679 |
Fax Number: | 8706737654 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | PT1005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |