Organization
MOUNTAINCREST REHAB OF BELLA VISTA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEWART T ONG PT (OWNER)
(479) 855-9348
Entity
Organization
Contact information
Practice address
1801 FOREST HILLS BLVD, STE #205, BELLA VISTA, AR 72715
(479) 855-9348
(479) 855-9358
Mailing address
1801 FOREST HILLS BLVD., STE #205, BELLA VISTA, AR 72715
(479) 855-9348
(479) 855-9358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT1741
AR
225100000X
Physical Therapist
PT2105
AR
225100000X
Physical Therapist
Primary
PT2113
AR
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143683721
—
AR
05
—
157687742
—
AR
01
—
5F289
BCBS
—
Enumeration date
04/26/2006
Last updated
04/25/2011
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