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Main Office Bryant Clinic 1306 Military Rd. Suite 1 Benton Arkansas 72015 Phone 501 481-8930 Fax 501 481-8914 www. Please call We welcome the opportunity to help your child AUTHORIZATION FOR SERVICES TO BE PROVIDED BY ATO 1 I hereby authorize Arkansas Therapy Outreach LLC ATO to provide the indicated therapy evaluation and treatment services if warranted by evaluation recommendations to my child according to the recommended Plan of Care POC. Artherapyoutreach. com New Referral Intake Form...
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