Organization
LANE PHYSICAL THERAPY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA J CRAWFORD (OFFICE ADMINISTRATOR)
(479) 967-9657
Entity
Organization
Contact information
Practice address
409 N ELMIRA AVE, RUSSELLVILLE, AR 72802-9624
(479) 967-9657
(479) 967-9658
Mailing address
409 N ELMIRA AVE, RUSSELLVILLE, AR 72802-9624
(479) 967-9657
(479) 967-9658
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1836
AR
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136075742
—
AR
Enumeration date
07/01/2006
Last updated
04/28/2026
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