Provider Demographics
NPI:1003036153
Name:OUACHITA PHYSICAL THERAPY SERVICES INC
Entity Type:Organization
Organization Name:OUACHITA PHYSICAL THERAPY SERVICES INC
Other - Org Name:OUACHITA REHABILITATION AND FITNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-394-7979
Mailing Address - Street 1:400 G CRESTWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953
Mailing Address - Country:US
Mailing Address - Phone:479-394-7979
Mailing Address - Fax:479-394-7667
Practice Address - Street 1:400 G CRESTWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953
Practice Address - Country:US
Practice Address - Phone:479-394-7979
Practice Address - Fax:479-394-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty