Organization
PYRAMID THERAPY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI MOUROT MS, OTR/L (PRESIDENT)
(501) 208-3564
Entity
Organization
Contact information
Practice address
1810 WARWICK HILLS LANE, CONWAY, AR 72034
(501) 208-3564
(501) 336-8235
Mailing address
PO BOX 11407, CONWAY, AR 72034-0025
(501) 208-3564
(501) 336-8235
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR799
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148912742
—
AR
01
—
5C127
BLUE CROSS BLUE SHIELD
AR
Enumeration date
08/30/2006
Last updated
04/08/2010
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