Organization
KICKSTART PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEANN SMITH MSPT (PHYSICAL THERAPIST)
(501) 472-4923
Entity
Organization
Contact information
Practice address
2920 GLOHAVEN DR, CONWAY, AR 72034-9656
(501) 733-6929
Mailing address
2920 GLOHAVEN DR, CONWAY, AR 72034-9656
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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