Individual
JAMES COREY COLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2525 S MARKET ST, STE 100, ROGERS, AR 72758-8163
(479) 770-5655
(479) 770-5656
Mailing address
PO BOX 1398, LOWELL, AR 72745-1398
(479) 770-5655
(479) 770-5656
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR1941
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155213721
—
AR
01
—
5Y103
BLUE CROSS BLUE SHEILD
AR
Enumeration date
04/21/2006
Last updated
04/15/2016
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