Basic Information
| Provider Information | |||||||||
| NPI: | 1801840616 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIVE RIVERS THERAPY SERVICES LIMITED PARTNERSHIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2655 THOMASVILLE RD | ||||||||
| Address2: | |||||||||
| City: | POCAHONTAS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724551202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702480800 | ||||||||
| FaxNumber: | 8702480802 | ||||||||
| Practice Location | |||||||||
| Address1: | 2655 THOMASVILLE RD | ||||||||
| Address2: | |||||||||
| City: | POCAHONTAS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724551202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702480800 | ||||||||
| FaxNumber: | 8702480802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 09/10/2014 | ||||||||
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| AuthorizedOfficialLastName: | BINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP, AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 7132977000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | JD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.