Organization
CUSTOM CARE THERAPY CORP.
Active
Organization
CUSTOM CARE THERAPY CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL COLE CHAFFIN MSPT (PHYSICAL THERAPIST)
(501) 812-6451
Entity
Organization
Contact information
Practice address
4600 EDGEMERE ST, N LITTLE ROCK, AR 72116-7424
(501) 812-6451
(501) 812-6451
Mailing address
4600 EDGEMERE ST, N LITTLE ROCK, AR 72116-7424
(501) 812-6451
(501) 812-6451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1583
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T405
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/03/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up