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Individual

MRS. BRENDA SUE SCANTLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT MS

Contact information

Practice address
4505 NORTH RUDY ROAD, VAN BUREN, AR 72956-9062
(479) 474-4011
(479) 474-4044
Mailing address
PO BOX 341, BONNEVILLE, AR 72927-0341
(479) 675-4918
(479) 474-4044

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1775
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5T191
BLUE CROSS BLUE SHIELD
Enumeration date
09/26/2006
Last updated
07/08/2007
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