Provider Demographics
NPI:1437486685
Name:MCKINNEY, BETHANY V (PT, DPT, CWS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:V
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PT, DPT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1823 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-1427
Mailing Address - Country:US
Mailing Address - Phone:252-489-8181
Mailing Address - Fax:
Practice Address - Street 1:1823 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-1427
Practice Address - Country:US
Practice Address - Phone:524-898-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4449225100000X
NCP10819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist