Organization
HORSE-PLAY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY ROBERTS (OWNER)
(479) 856-6400
Entity
Organization
Contact information
Practice address
3801 JOHNSON MILL BLVD STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
Mailing address
3801 JOHNSON MILL BLVD STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
PT3719
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT3719
ARKANSAS STATE BOARD OF PHYSICAL THERAPY
AR
Enumeration date
02/29/2016
Last updated
02/29/2016
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