Healthcare Provider Details

I. General information

NPI: 1235780115
Provider Name (Legal Business Name): HEALTHPRO HERITAGE REHAB & FITNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W 6TH ST
MOUNTAIN HOME AR
72653-3421
US

IV. Provider business mailing address

536 OLD HOWELL RD
GREENVILLE SC
29615-1969
US

V. Phone/Fax

Practice location:
  • Phone: 870-425-6868
  • Fax:
Mailing address:
  • Phone: 864-244-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JULIE MCGLASSON
Title or Position: DIRECTOR, LICENSING/CERTIFICATION
Credential:
Phone: 615-406-3997