Provider Demographics
NPI:1689669897
Name:SAMI JO MAGOFFIN PA
Entity Type:Organization
Organization Name:SAMI JO MAGOFFIN PA
Other - Org Name:PHYSICAL THERAPY PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MAGOFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:501-922-1686
Mailing Address - Street 1:140 CORDOBA CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-4020
Mailing Address - Country:US
Mailing Address - Phone:501-922-1686
Mailing Address - Fax:501-922-9735
Practice Address - Street 1:140 CORDOBA CENTER DR
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-4020
Practice Address - Country:US
Practice Address - Phone:501-922-1686
Practice Address - Fax:501-922-9735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C310Medicare ID - Type Unspecified