Organization
HORSE-PLAY OUTDOOR CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA RUCKENBROD DPT (EXECUTIVE DIRECTOR)
(479) 283-7899
Entity
Organization
Contact information
Practice address
902 GRANT AVE, PRAIRIE GROVE, AR 72753-8417
(479) 283-7899
Mailing address
902 GRANT AVE, PRAIRIE GROVE, AR 72753-8417
(479) 283-7899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
225100000X
Physical Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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