Stevens, Richard Dale

Stevens, Richard Dale is an individual health care provider with primary practice located at 2010 Active Way , Benton AR 72019-0000. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Stevens, Richard Dale can be contacted via phone (501) 315-0984.

Contact Information

Primary practice address
2010 Active Way Benton AR 72019-0000
Fax:
Website:

Health care specialties

Profile Details

NPI number 1073596086
LBN Legal business name Stevens, Richard Dale
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Oct 4th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073596086 NPPES
Arkansas MEDICAID 126920721

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