Individual
MR. BRYAN RAY RENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4801 FAIRWAY AVE, NORTH LITTLE ROCK, AR 72116-8009
(501) 758-1300
(501) 758-1316
Mailing address
4801 FAIRWAY AVE, NORTH LITTLE ROCK, AR 72116-8009
(501) 758-1300
(501) 758-1316
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2221
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155038742
—
AR
01
—
5G239
BCBS GROUP
AR
01
—
5G468
MEDICARE GROUP
AR
01
—
5U797
BCBS
AR
Enumeration date
02/23/2006
Last updated
08/22/2011
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