Organization
ADVANCED THERAPY CONNECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL MATSON (ORGANIZER)
(870) 847-2448
Entity
Organization
Contact information
Practice address
75 HIGHWAY 62 412 STE L, ASH FLAT, AR 72513-9629
(870) 262-7480
Mailing address
PO BOX 723, CHEROKEE VILLAGE, AR 72525-0723
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161958721
—
AR
Enumeration date
06/07/2017
Last updated
06/07/2017
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