Organization
PEDIATRIC PHYSICAL THERAPY OF NEA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY D VANHORN (OWNER)
(870) 932-5551
Entity
Organization
Contact information
Practice address
151 SOUTHWEST DR, JONESBORO, AR 72401-5828
(870) 932-5551
(870) 932-5552
Mailing address
151 SOUTHWEST DR, JONESBORO, AR 72401-5828
(870) 932-5551
(870) 932-5552
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C409
BLUECROSS PROVIDER #
AR
Enumeration date
04/25/2006
Last updated
08/22/2020
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