Provider Demographics
NPI:1710382643
Name:ARKANSAS PHYSICAL THERAPY SPECIALTIES LLC
Entity Type:Organization
Organization Name:ARKANSAS PHYSICAL THERAPY SPECIALTIES LLC
Other - Org Name:ARKANSAS PHYSICAL THERAPY SPECIALTIES AND ORTHOPEDIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-650-5907
Mailing Address - Street 1:115 POINTER TRL W STE B
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-2236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 POINTER TRL W STE B
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2236
Practice Address - Country:US
Practice Address - Phone:479-650-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1885261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy