Healthcare Provider Details

I. General information

NPI: 1003097486
Provider Name (Legal Business Name): APPALACHIAN REHABILITATION TEAM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 08/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 E MOUNTAIN PKWY
SALYERSVILLE KY
41465-8377
US

IV. Provider business mailing address

149 MEDICAL PLAZA LANE STE A
WHITESBURG KY
41858-9323
US

V. Phone/Fax

Practice location:
  • Phone: 606-349-8284
  • Fax: 606-349-8285
Mailing address:
  • Phone: 606-632-1188
  • Fax: 606-632-0075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004532
License Number StateKY

VIII. Authorized Official

Name: MR. JOHN PHILIP BENTLEY
Title or Position: PRESIDENT
Credential: PT
Phone: 606-632-1188