Individual
KEITH REBSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1110 CARROLL RD, PARAGOULD, AR 72450-6007
(870) 897-2372
Mailing address
PO BOX 1545, PARAGOULD, AR 72451-1545
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4230
AR
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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