Provider Demographics
NPI:1023769015
Name:WARRIOR CONCIERGE PHYSICAL THERAPY
Entity type:Organization
Organization Name:WARRIOR CONCIERGE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:501-276-6929
Mailing Address - Street 1:108 HOBACK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-8065
Mailing Address - Country:US
Mailing Address - Phone:501-276-6929
Mailing Address - Fax:
Practice Address - Street 1:108 HOBACK RIDGE RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-8065
Practice Address - Country:US
Practice Address - Phone:501-276-6929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty