Crystal Like, PTA
Individual provider Active NPI Physical Therapy Assistant · Brinkley, AR
NPI 1922769736 · NPPES record last updated Jan 6, 2022
Key facts
- NPI
- 1922769736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA4276 (AR)
- Practice address
- 1116 N New York Ave
Brinkley, AR 72021-2126 - Phone
- (870) 734-1155
- NPI assigned
- Jan 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA4276 | AR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Therapy | Past |
Accepting new patients | |
| Monroe County Human Development Center, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA4276 | AR | Yes |
Addresses
Primary practice location
1116 N New York Ave
Brinkley, AR 72021-2126
Mailing address
15 County Road 6550
Colt, AR 72326-9451
Other providers in Brinkley, AR
- Joseph S. Barker DDS PA
- Joseph S. Barker DDS, PA.
- Kah Development 4, LLC
- Clayton Jerome Knupp
- Marla Denise Lane
- Courtney B Manatt
- Medi-Mart Pharmacy
- Medi-Mart Pharmacy Inc
- Monroe County Human Development Center, Inc.
- Andrew Neaville
All providers in Brinkley, AR · Physical Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.