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General NPI Number Information
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NPI Number | 1205346111
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Entity Type | Organization
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Legal Business Name | REHABILITATION NETWORK OUTPATIENT SERVICES LLC
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 93 RODEN MILL RD
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City | CONWAY
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State | AR
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Zip | 72032-9555
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Country | US
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Telephone | 479-858-2760
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Fax | 479-858-2760
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Provider Business Mailing Address
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Address Line | PO BOX 202
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City | CONWAY
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State | AR
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Zip | 72033-0202
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Country | US
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Telephone | 501-548-6003
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Fax | 844-209-1709
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BECKY ANNE CRENSHAW
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Credential | MRC, CRC
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Telephone | 501-548-6003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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