Source Therapy Solutions Pllc | |
1721 Martin Luther King Blvd, Suite I, Malvern, AR 72104-2085 | |
(501) 249-5354 | |
Not Available |
Full Name | Source Therapy Solutions Pllc |
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Type | Facility |
Speciality | Physical Therapist |
Location | 1721 Martin Luther King Blvd, Malvern, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194061309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | PT3097 (Arkansas) | Primary |
Provider Name | Michael R Schoultz |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912143975 PECOS PAC ID: 1355491515 Enrollment ID: I20090609000432 |
Mailing Address | Practice Location Address |
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Source Therapy Solutions Pllc 1721 Martin Luther King Blvd, Suite I, Malvern, AR 72104-2085 Ph: () - | Source Therapy Solutions Pllc 1721 Martin Luther King Blvd, Suite I, Malvern, AR 72104-2085 Ph: (501) 249-5354 |
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