Provider Demographics
NPI:1326008863
Name:CHILDREN'S THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:CHILDREN'S THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYMBRLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:479-530-5791
Mailing Address - Street 1:2474 E JOYCE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4519
Mailing Address - Country:US
Mailing Address - Phone:479-521-8326
Mailing Address - Fax:479-521-5439
Practice Address - Street 1:2474 E JOYCE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4519
Practice Address - Country:US
Practice Address - Phone:479-521-8326
Practice Address - Fax:479-521-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 23092251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148019742Medicaid
AR5C867OtherBLUE CROSS BLUE SHEILD