Provider Demographics
NPI:1619417722
Name:PHYSICAL THERAPY SPECIALISTS OF COWAY
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS OF COWAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-733-3655
Mailing Address - Street 1:2425 PRINCE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3701
Mailing Address - Country:US
Mailing Address - Phone:501-470-3500
Mailing Address - Fax:
Practice Address - Street 1:2425 PRINCE ST STE 3
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3701
Practice Address - Country:US
Practice Address - Phone:501-470-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty