Organization
PROFESSIONAL FOR AGILITY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELILA M BEJERANO (ADMINISTRATIVE OFFICER)
(870) 704-9800
Entity
Organization
Contact information
Practice address
212 S LINCOLN ST, STE D, LOWELL, AR 72745-9782
(870) 704-9800
(479) 770-5656
Mailing address
PO BOX 861, HARRISON, AR 72602-0861
(870) 704-9800
(479) 770-5656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/19/2011
Last updated
01/19/2011
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