Organization
CAROLYN MOODY PHYSICAL THERAPY CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN MOODY (OWNER)
(870) 932-5551
Entity
Organization
Contact information
Practice address
217 E CHERRY AVE, JONESBORO, AR 72401-3372
(870) 932-5551
Mailing address
217 E CHERRY AVE, JONESBORO, AR 72401-3372
(870) 932-5551
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
819
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165343742
—
AR
Enumeration date
10/18/2007
Last updated
10/18/2007
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