# RIVER VALLEY PEDIATRIC THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982644753
- **Authorized official:** SARA J WHITLOCK (OWNER)
- **Authorized official phone:** (479) 890-5494

## Contact information

- **Practice address:** 2703 W MAIN ST, RUSSELLVILLE, AR 72801-2456
- **Practice address phone:** (479) 890-5494
- **Practice address fax:** (479) 968-0069
- **Mailing address:** PO BOX 9178, RUSSELLVILLE, AR 72811-9178
- **Mailing address phone:** (479) 968-4273
- **Mailing address fax:** (479) 968-1363

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | NULL | Yes |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 08/22/2020