Miracle Kids Success Academy Central

NPI #1174234322 in Jonesboro, Arkansas

Provider Information

NPI Number: 1174234322
Entity Type: Organization
Organization Name: Miracle Kids Success Academy Central
Primary Specialty: Physical Therapist
Enumeration Date: Dec 8, 2022
Last Updated: Dec 8, 2022

Practice Location

Address: 1607 STONE ST
City: Jonesboro
State: Arkansas
ZIP Code: 72401-5332
Phone: (870) 336-4100

Authorized Official

Name: SHELLY KELLER, MCD, CCC-SLP
Title: CEO
Phone: (870) 336-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapy Assistant	224Z00000X
Physical Therapy Assistant	225200000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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