Organization
CHILDREN'S THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYM HANNAH (OWNER)
(479) 521-8326
Entity
Organization
Contact information
Practice address
2474 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-4932
(479) 521-8326
Mailing address
2474 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-4932
(479) 521-8326
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2309
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132734786
EI PROVIDER
AR
Enumeration date
03/05/2015
Last updated
03/05/2015
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