Provider Demographics
NPI:1679171383
Name:ABOVE AND BEYOND MOBILE THERAPY PLLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND MOBILE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:501-733-1483
Mailing Address - Street 1:510 SPRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-2336
Mailing Address - Country:US
Mailing Address - Phone:501-733-1483
Mailing Address - Fax:
Practice Address - Street 1:510 SPRIGGS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-2336
Practice Address - Country:US
Practice Address - Phone:501-733-1483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty