Organization
MAUMELLE PHYSICAL THERAPY, INC.
Active
Organization
MAUMELLE PHYSICAL THERAPY, INC.
Active
Other names
McMaster Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TASI E WYATT (OWNER)
(501) 327-2235
Entity
Organization
Contact information
Practice address
3605 COLLEGE AVE, CONWAY, AR 72034
(501) 327-2235
(501) 327-1601
Mailing address
3605 COLLEGE AVE, CONWAY, AR 72034
(501) 327-2235
(501) 327-1601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C951
BCBS
—
Enumeration date
03/28/2006
Last updated
07/17/2014
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