Healthcare Provider Details

I. General information

NPI: 1679104467
Provider Name (Legal Business Name): BETTER LIFE HEART THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MEDICAL LN STE C
CONWAY AR
72034-4918
US

IV. Provider business mailing address

13 WOODRUFF LN
CONWAY AR
72032-9541
US

V. Phone/Fax

Practice location:
  • Phone: 501-428-6693
  • Fax:
Mailing address:
  • Phone: 501-428-6693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CONNIE KUBLI
Title or Position: PRESIDENT
Credential:
Phone: 501-428-6693