Organization
KINGS RIVER PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY WADE HILL RPT (PRESIDENT)
(870) 423-3316
Entity
Organization
Contact information
Practice address
402 W COLLEGE AVE., BERRYVILLE, AR 72616-3142
(870) 423-3316
(870) 423-3177
Mailing address
402 W COLLEGE AVE., BERRYVILLE, AR 72616-3142
(870) 423-3316
(870) 423-3177
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT2047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154777742
—
AR
01
—
5Y014
BCBS GROUP
AR
Enumeration date
05/30/2007
Last updated
05/06/2013
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