Provider Demographics
NPI:1467501452
Name:PHYSICAL THERAPY PLUS INC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:N
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-534-4030
Mailing Address - Street 1:2302 W 28TH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-5050
Mailing Address - Country:US
Mailing Address - Phone:870-534-4030
Mailing Address - Fax:870-534-4645
Practice Address - Street 1:2302 W 28TH AVE
Practice Address - Street 2:STE B
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5050
Practice Address - Country:US
Practice Address - Phone:870-534-4030
Practice Address - Fax:870-534-4645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C930Medicare ID - Type Unspecified