Spine and Sports Therapy LLC
Organization Active NPI Physical Therapist · Lowell, AR
NPI 1730454935 · NPPES record last updated Mar 21, 2012
Key facts
- NPI
- 1730454935
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- SPINE AND SPORTS THERAPY LLC
- Practice address
- 125 S Bloomington St
Suite a
Lowell, AR 72745-9493 - Phone
- (479) 770-5655
- Fax
- (479) 770-5656
- NPI assigned
- Mar 21, 2012
- Organization subpart
- No
Authorized official
- Name
- Norma Lee Stockstill
- Title
- Office Manager
- Phone
- (870) 280-8442
Practitioners 32
-
Joel Damarillo Sebag, RPT
-
Sheila Renee Wolf, OTRL
-
Alex Wade Baker, PA-C
-
Lilly Bickford, COTA/L
-
Jill J Broyles, COTA
-
Clare Anastasia Doss, PT, DPT
-
Jessica A Durr, DPT
-
Joanne A Goluch, P.T.
-
Sterling Granger, PTA
-
Jamie Holden, PTA
-
Kristin Jones, COTA
-
Lindsey Jones, COTA
-
Danyal Loftin, PTA
-
Randal Zane Rankin, MS CCC SLP
-
Sarah Jordan Reeves, OTR/L
-
Stephanie Ann Spiva, COTA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120515000560 | AR | Part B Supplier - Clinic/Group Practice | 9537322383 |
Receives reassigned benefits from 4 practitioners Practice locations: Eureka Springs, AR; Rogers, AR |
National Provider Directory
Locations
105 Passion Play Rd
Ste F
Eureka Springs, AR 72632
Phone (479) 900-0042
350 E Millsap Rd
Ste 6
Fayetteville, AR 72703
Phone (479) 444-6768
3900 N Parkview Dr
#203
Fayetteville, AR 72703
Phone (479) 444-6768
722 Phillips Pl
Huntsville, AR 72740
Phone (479) 420-7846
201 S 19th St
Ste A
Rogers, AR 72758
Phone (479) 372-3700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X |
Addresses
Primary practice location
125 S Bloomington St
Suite a
Lowell, AR 72745-9493
Mailing address
PO Box 1938
Lowell, AR 72745-1938
Phone (479) 770-5655
Other providers in Lowell, AR
- Amy Danielle Seay
- Makayla Jane Shields
- Tonya Y Skinner
- John T Smiley
- Crystal Michelle Sparks
- Sprout Pediatric Dentistry
- Jami Lynn Spurling
- Aleisha Joyce Spytma-Woods
- Stephen Woodsen Stagg
- Melissa Rose Stewart
All providers in Lowell, AR · Physical Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.