Organization
NORTHWEST ARKANSAS PEDIATRIC THERAPY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELIA D WILKERSON MS,PT (PRESIDENT)
(479) 451-9434
Entity
Organization
Contact information
Practice address
827 WEST SLACK STREET, PEA RIDGE, AR 72751-3703
(479) 451-9434
(479) 488-6220
Mailing address
PO BOX 585, PEA RIDGE, AR 72751-0585
(479) 451-9434
(479) 488-6220
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT1625
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136029742
—
AR
05
—
142245716
—
AR
01
—
5C140
INSURANCE
AR
Enumeration date
05/03/2007
Last updated
07/30/2010
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