Healthcare Provider Details

I. General information

NPI: 1053232983
Provider Name (Legal Business Name): REGAN RESZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3293 MAYBANK HWY UNIT 201
JOHNS ISLAND SC
29455-4940
US

IV. Provider business mailing address

2920 N HUGHMOUNT RD
FAYETTEVILLE AR
72704-5910
US

V. Phone/Fax

Practice location:
  • Phone: 854-800-9890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP060800T
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5874
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: