Individual
MR. RICHARD DALE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2010 ACTIVE WAY, BENTON, AR 72019-0000
(501) 315-0984
Mailing address
2010 ACTIVE WAY, BENTON, AR 72019-0000
(501) 315-0984
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
288
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126920721
—
AR
Enumeration date
11/23/2005
Last updated
10/04/2012
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