Horse-Play Outdoor Center, INC
Pediatrics in Prairie Grove, AR. Organization (NPI-2).
NPI number1982161402
StatusActive
Last updated in NPPESFeb 21, 2019
Details
- NPI
- 1982161402
- Entity type
- Organization (NPI-2)
- Legal business name
- Horse-Play Outdoor Center, INC
- Organization subpart
- No
- Enumeration date
- Feb 21, 2019
- Last updated
- Feb 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
| 225100000X | Physical Therapist | – | – | |
| 261QH0700X | Clinic/Center, Hearing and Speech | – | – | |
| 261QX0100X | Clinic/Center, Occupational Medicine | – | – |
Practice location
902 Grant AvePrairie Grove, AR 72753-8417
Phone 479-283-7899
Mailing address
902 Grant AvePrairie Grove, AR 72753-8417
Phone 479-283-7899
Authorized official
Sara Ruckenbrod
Executive Director
4792837899
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