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General NPI Number Information
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NPI Number | 1437696440
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Entity Type | Organization
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Legal Business Name | BENTONVILLE PHYSICAL THERAPY SPECIALISTS
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 907 SE VILLAGE LOOP STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-2229
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Country | US
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Telephone | 479-268-6040
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Fax | 479-431-5098
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Provider Business Mailing Address
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Address Line | 907 SE VILLAGE LOOP STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-2229
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Country | US
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Telephone | 479-268-6040
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Fax | 479-431-5098
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | CHRISTIAN CHARLES ROBERTOZZI
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Credential | PT, DPT
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Telephone | 479-268-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT 4240
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License Number State | AR
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