Provider Demographics
NPI:1457918468
Name:NEXT PHASE PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:NEXT PHASE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DJUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:501-208-8063
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-0363
Mailing Address - Country:US
Mailing Address - Phone:501-208-8063
Mailing Address - Fax:501-354-1133
Practice Address - Street 1:1307 E HARDING ST STE B
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-2239
Practice Address - Country:US
Practice Address - Phone:501-208-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty