Organization
FENTER PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY FENTER PT (CEO/PT)
(870) 394-7000
Entity
Organization
Contact information
Practice address
200 W BROADWAY ST, WEST MEMPHIS, AR 72301-3904
(870) 394-7000
(870) 394-7001
Mailing address
605 N RIVERWIND, MARION, AR 72364
(870) 394-7000
(870) 394-7001
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198689716
—
AR
Enumeration date
03/27/2014
Last updated
07/15/2014
Update your record
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