Provider Demographics
NPI:1508892100
Name:CENTRAL HEALTH THERAPY AND REHABILIATION LLC
Entity Type:Organization
Organization Name:CENTRAL HEALTH THERAPY AND REHABILIATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-235-1100
Mailing Address - Street 1:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0548
Mailing Address - Country:US
Mailing Address - Phone:870-235-1100
Mailing Address - Fax:870-235-3030
Practice Address - Street 1:624 N DUDNEY RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-3050
Practice Address - Country:US
Practice Address - Phone:870-235-1100
Practice Address - Fax:870-235-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
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
AR5C463Medicare ID - Type Unspecified