Provider Demographics
NPI:1922309475
Name:THERAPEUTIC EXERCISE REHABILITATION & WELLNESS, INC
Entity Type:Organization
Organization Name:THERAPEUTIC EXERCISE REHABILITATION & WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARTELL
Authorized Official - Middle Name:DANTE
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-292-9280
Mailing Address - Street 1:1728 WESTWOOD CV
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4793
Mailing Address - Country:US
Mailing Address - Phone:870-292-9280
Mailing Address - Fax:
Practice Address - Street 1:1728 WESTWOOD CV
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4793
Practice Address - Country:US
Practice Address - Phone:870-292-9280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-14
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty