Healthcare Provider Details

I. General information

NPI: 1073845657
Provider Name (Legal Business Name): CHRISTI BJORNBERG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 SALEM RD
CONWAY AR
72034-6159
US

IV. Provider business mailing address

PO BOX 933
GREENBRIER AR
72058-0933
US

V. Phone/Fax

Practice location:
  • Phone: 501-581-6045
  • Fax: 501-514-3722
Mailing address:
  • Phone: 501-581-6045
  • Fax: 501-514-3722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number3534
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: