Individual
MR. JASON LEE TEBEEST
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1350 S GUTENSOHN RD, STE 10, SPRINGDALE, AR 72762-5117
(479) 751-7122
(479) 751-7292
Mailing address
1350 S GUTENSOHN RD, STE 10, SPRINGDALE, AR 72762-5117
(479) 751-7122
(479) 751-7292
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2350
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X613
BCBS PROVIDER#
AR
Enumeration date
01/13/2006
Last updated
07/08/2007
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