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General NPI Number Information
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NPI Number | 1437486685
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Entity Type | Individual
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Provider Name | BETHANY V. MCKINNEY PT, DPT, CWS
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Gender | Female
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 1823 CUMBERLAND ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1427
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Country | US
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Telephone | 524-898-1812
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Fax |
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Provider Business Mailing Address
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Address Line | 1823 CUMBERLAND ST
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City | LITTLE ROCK
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State | AR
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Zip | 72206-1427
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Country | US
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Telephone | 252-489-8181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT4449
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P10819
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License Number State | NC
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