Organization
PREMIERE PHYSICAL THERAPY AND SPORTS REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN SANDERS (OWNER)
(479) 273-9933
Entity
Organization
Contact information
Practice address
203 SE 22ND ST, SUITE 9, BENTONVILLE, AR 72712-4310
(479) 273-9933
(479) 273-9935
Mailing address
203 SE 22ND ST, SUITE 9, BENTONVILLE, AR 72712-4310
(479) 273-9933
(479) 273-9935
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164492742
—
AR
01
—
19435
EVOLUTIONS
AR
01
—
5A315
BCBS
AR
01
—
712695
ACN GROUP
AR
01
—
796247
HEALTHLINK
AR
Enumeration date
03/05/2007
Last updated
08/17/2017
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