Provider Demographics
NPI:1215816715
Name:GUIDED GROWTH THERAPY PLLC
Entity type:Organization
Organization Name:GUIDED GROWTH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-888-1061
Mailing Address - Street 1:162 CHEYENNE CT
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72519-9732
Mailing Address - Country:US
Mailing Address - Phone:870-888-1061
Mailing Address - Fax:
Practice Address - Street 1:162 CHEYENNE CT
Practice Address - Street 2:
Practice Address - City:JORDAN
Practice Address - State:AR
Practice Address - Zip Code:72519-9732
Practice Address - Country:US
Practice Address - Phone:870-888-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1215403670Medicaid