Organization
UNBRIDLED HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRICA LINN WEATHERFORD MS, OTR/L (PRESIDENT)
(501) 240-5225
Entity
Organization
Contact information
Practice address
9900 PRICE COFFEE RD, BENTONVILLE, AR 72712
(479) 250-9838
(479) 268-3473
Mailing address
PO BOX 209, AVOCA, AR 72711
(479) 250-9838
(479) 268-3473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
03/18/2020
Last updated
03/18/2020
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