Provider Demographics
NPI:1881848380
Name:SPORTS THERAPY OF LITTLE ROCK
Entity Type:Organization
Organization Name:SPORTS THERAPY OF LITTLE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:877-932-7331
Mailing Address - Street 1:10 VIEWPOINTE COVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223
Mailing Address - Country:US
Mailing Address - Phone:877-932-7331
Mailing Address - Fax:
Practice Address - Street 1:10 VIEWPOINTE COVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223
Practice Address - Country:US
Practice Address - Phone:877-932-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty