Provider Demographics
NPI:1386623536
Name:KIDS AND COMPANY, LLC
Entity type:Organization
Organization Name:KIDS AND COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:870-886-8715
Mailing Address - Street 1:423 EASTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-2027
Mailing Address - Country:US
Mailing Address - Phone:870-886-8715
Mailing Address - Fax:870-886-2653
Practice Address - Street 1:423 EASTWOOD CIR
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-2027
Practice Address - Country:US
Practice Address - Phone:870-886-8715
Practice Address - Fax:870-886-2653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2316174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F006OtherBCBS GROUP #