Provider Demographics
NPI:1497457527
Name:ORTHOPEDIC MANUAL THERAPY INSTRUCTION LTD
Entity Type:Organization
Organization Name:ORTHOPEDIC MANUAL THERAPY INSTRUCTION LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-366-0714
Mailing Address - Street 1:930 WINGATE ST BLDG SUITEE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-4856
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 WINGATE ST BLDG SUITEE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-4856
Practice Address - Country:US
Practice Address - Phone:501-366-0714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty