Organization
PROGRESSIVE BALANCE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER LYNN VINCENZO PT, MPH, CHES, GCS (OWNER)
(479) 372-8783
Entity
Organization
Contact information
Practice address
1706 NW MYSTIC AVE, BENTONVILLE, AR 72712-8094
(479) 372-8783
Mailing address
1706 NW MYSTIC AVE, BENTONVILLE, AR 72712-8094
(479) 372-8783
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3069
AR
Other
Enumeration date
05/22/2014
Last updated
05/22/2014
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