Individual
CELINO CINCO RENALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
593 HORSEBARN RD, #101, ROGERS, AR 72758-8795
(479) 271-9191
(479) 271-9196
Mailing address
PO BOX 3267, BENTONVILLE, AR 72712-7713
(479) 271-9191
(479) 271-9196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1717
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y445
BLUE CROSS
AR
Enumeration date
07/18/2006
Last updated
05/21/2008
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