Organization
PREMIERE PHYSICAL THERAPY AND SPORTS REHAB LLC
Active
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
Update your record
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