Miracle Kids Success Academy Of Trumann
Physical Therapist in Trumann, AR. Organization (NPI-2).
NPI number1063979243
StatusActive
Last updated in NPPESFeb 25, 2019
Details
- NPI
- 1063979243
- Entity type
- Organization (NPI-2)
- Legal business name
- Miracle Kids Success Academy Of Trumann
- Organization subpart
- No
- Enumeration date
- Feb 25, 2019
- Last updated
- Feb 25, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
1005 Balcom LnTrumann, AR 72472-9502
Phone 870-761-6680
Mailing address
1900 Stillwater DrJonesboro, AR 72404-9119
Phone 870-932-3600
Authorized official
Shelly Keller
Ceo
8707616680
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All 12 Physical Therapist providers in Trumann · All 357 providers in Trumann
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