Provider Demographics
NPI:1346659620
Name:ARKANSAS THERAPY PROFESSIONALS
Entity Type:Organization
Organization Name:ARKANSAS THERAPY PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:501-593-2707
Mailing Address - Street 1:257 SIDON RD
Mailing Address - Street 2:
Mailing Address - City:ROSE BUD
Mailing Address - State:AR
Mailing Address - Zip Code:72137-9771
Mailing Address - Country:US
Mailing Address - Phone:501-593-2707
Mailing Address - Fax:707-202-3865
Practice Address - Street 1:257 SIDON RD
Practice Address - Street 2:
Practice Address - City:ROSE BUD
Practice Address - State:AR
Practice Address - Zip Code:72137-9771
Practice Address - Country:US
Practice Address - Phone:501-593-2707
Practice Address - Fax:707-202-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty