Provider Demographics
NPI:1720387145
Name:GAYLA LIKE PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:GAYLA LIKE PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLA
Authorized Official - Middle Name:DEANNA
Authorized Official - Last Name:LIKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:870-633-4443
Mailing Address - Street 1:311 SFC 1003
Mailing Address - Street 2:
Mailing Address - City:COLT
Mailing Address - State:AR
Mailing Address - Zip Code:72326-8516
Mailing Address - Country:US
Mailing Address - Phone:870-633-4443
Mailing Address - Fax:870-633-0647
Practice Address - Street 1:311 SFC 1003
Practice Address - Street 2:
Practice Address - City:COLT
Practice Address - State:AR
Practice Address - Zip Code:72326-8516
Practice Address - Country:US
Practice Address - Phone:870-633-4443
Practice Address - Fax:870-633-0647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2967225100000X
ARSP#2616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty