Organization
THEREX WELLNESS AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARTELL DANTE TREADWELL DPT (OWNER)
(870) 926-0271
Entity
Organization
Contact information
Practice address
3704 S CARAWAY RD, SUITE 4, JONESBORO, AR 72404-0656
(870) 926-0271
Mailing address
3704 S CARAWAY RD, SUITE 4, JONESBORO, AR 72404-0656
(870) 926-0271
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3059
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3730146
MEDICARE GROUP NUMBER
TN
Enumeration date
01/07/2010
Last updated
01/07/2010
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