Provider Demographics
NPI:1366535213
Name:HELENA PHYSICAL THERAPY AND SPORTS MEDICINE, INC.
Entity type:Organization
Organization Name:HELENA PHYSICAL THERAPY AND SPORTS MEDICINE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:870-338-8844
Mailing Address - Street 1:116 HICKORY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-2302
Mailing Address - Country:US
Mailing Address - Phone:870-338-8844
Mailing Address - Fax:870-338-8108
Practice Address - Street 1:116 HICKORY HILLS DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-2302
Practice Address - Country:US
Practice Address - Phone:870-338-8844
Practice Address - Fax:870-338-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C864Medicare ID - Type UnspecifiedGROUP NUMBER