Provider Demographics
NPI:1457905234
Name:ARKANSAS OSTEOPRACTIC PLLC
Entity Type:Organization
Organization Name:ARKANSAS OSTEOPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:MILHOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:817-675-0782
Mailing Address - Street 1:10301 N. RODNEY PARHAM RD. STE. B-3
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227
Mailing Address - Country:US
Mailing Address - Phone:817-675-0782
Mailing Address - Fax:
Practice Address - Street 1:10301 N. RODNEY PARHAM RD. STE. B-3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227
Practice Address - Country:US
Practice Address - Phone:817-675-0782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty