Organization
MOUNTAINCREST REHAB OF BELLA VISTA, INC.
Active
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
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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