Organization
RADIANCE PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER KLOSTER OTR/L (OWNER)
(479) 282-4477
Entity
Organization
Contact information
Practice address
207 NW HIGHLAND RD, BENTONVILLE, AR 72712-7198
(479) 282-4477
(479) 391-5269
Mailing address
207 NW HIGHLAND RD, BENTONVILLE, AR 72712-7198
(479) 282-4477
(479) 391-5269
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/08/2025
Last updated
03/03/2025
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