Organization
BENTON PHYSICAL THERAPY
Active
Parent organization
PRO-ACTIVE REHAB, INC.
Other names
Benton Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRO-ACTIVE REHAB, INC.
Authorized official
JAMES RICHARD LEE PT (VICE PRESIDENT)
(501) 778-4960
Entity
Organization
Contact information
Practice address
1308 MILITARY RD, BENTON, AR 72015-2911
(501) 778-4960
Mailing address
1308 MILITARY RD, BENTON, AR 72015-2911
(501) 778-4960
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1316
AR
Other
Enumeration date
10/03/2006
Last updated
04/02/2021
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