Healthcare Provider Details

I. General information

NPI: 1346938297
Provider Name (Legal Business Name): BENTLEY REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 HAMRIC DR E STE 3
OXFORD AL
36203-8047
US

IV. Provider business mailing address

1716 HAMRIC DR E STE 3
OXFORD AL
36203-8047
US

V. Phone/Fax

Practice location:
  • Phone: 256-208-5600
  • Fax:
Mailing address:
  • Phone: 256-208-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY ANNE BENTLEY
Title or Position: OWNER
Credential: PT, DPT
Phone: 334-312-4663