Provider Demographics
NPI:1194746438
Name:CABOT PHYSICAL THERAPY
Entity type:Organization
Organization Name:CABOT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:L
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:501-843-7157
Mailing Address - Street 1:1909 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2209
Mailing Address - Country:US
Mailing Address - Phone:501-843-7157
Mailing Address - Fax:501-843-4617
Practice Address - Street 1:1909 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2209
Practice Address - Country:US
Practice Address - Phone:501-843-7157
Practice Address - Fax:501-843-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT1094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C360Medicare ID - Type Unspecified