Provider Demographics
NPI:1306801402
Name:LOUKS, SUSAN (PT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:LOUKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11121 N RODNEY PARHAM RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4158
Mailing Address - Country:US
Mailing Address - Phone:501-765-3195
Mailing Address - Fax:501-613-0886
Practice Address - Street 1:11121 N RODNEY PARHAM RD STE 2A
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4158
Practice Address - Country:US
Practice Address - Phone:501-765-3195
Practice Address - Fax:501-613-0886
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR142864721Medicaid
AR5U531OtherBLUE CROSS/BLUE SHIELD
7970291OtherAETNA
4859717OtherCIGNA
AR5U531OtherBLUE CROSS/BLUE SHIELD