Organization
SALINE COUNTY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL GREEN PT (OWNER)
(501) 315-0639
Entity
Organization
Contact information
Practice address
1115 FERGUSON DR, BENTON, AR 72015-3512
(501) 315-0639
(501) 315-7278
Mailing address
1115 FERGUSON DR, BENTON, AR 72015-3512
(501) 315-0639
(501) 315-7278
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117948742
—
AR
Enumeration date
07/31/2006
Last updated
06/05/2008
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