Provider Demographics
NPI:1912339771
Name:MOUNT CARMEL PHYSICAL THERAPY CENTER, PLLC
Entity Type:Organization
Organization Name:MOUNT CARMEL PHYSICAL THERAPY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY STAFF
Authorized Official - Prefix:MRS
Authorized Official - First Name:REMEDIOS
Authorized Official - Middle Name:MAGTOTO
Authorized Official - Last Name:ADAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:870-715-2705
Mailing Address - Street 1:197 S. WALMART DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-1984
Mailing Address - Country:US
Mailing Address - Phone:870-204-6070
Mailing Address - Fax:870-204-6296
Practice Address - Street 1:197 S. WALMART DRIVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-1984
Practice Address - Country:US
Practice Address - Phone:870-204-6070
Practice Address - Fax:870-204-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty