Provider Demographics
NPI:1346245842
Name:APTC OF NORTH LITTLE ROCK, INC
Entity Type:Organization
Organization Name:APTC OF NORTH LITTLE ROCK, INC
Other - Org Name:ADVANCED PHYSICAL THERAPY OF NORTH LITTLE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-224-5454
Mailing Address - Street 1:4540 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7309
Mailing Address - Country:US
Mailing Address - Phone:501-758-5555
Mailing Address - Fax:501-758-5941
Practice Address - Street 1:4540 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7309
Practice Address - Country:US
Practice Address - Phone:501-758-5555
Practice Address - Fax:501-758-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0000000192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4657970OtherAETNA
ARP00855769OtherRAILROAD MEDICARE
ARDA7015OtherRAILROAD MEDICARE GROUP
AR130502742Medicaid
ARP00855756OtherRAILROAD MEDICARE
AR374964900OtherOWCP: OFFICE OF WORK COMP
AR5F776OtherMEDICARE NUMBER
ARDN8325OtherMEDICARE RAILROAD
AR374964900OtherOWCP: OFFICE OF WORK COMP
AR130502742Medicaid