Provider Demographics
NPI:1396555942
Name:CLEAVENGER, RHONDA
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:CLEAVENGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 FLORENTINE RD
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-6030
Mailing Address - Country:US
Mailing Address - Phone:479-586-9507
Mailing Address - Fax:
Practice Address - Street 1:5206 W VILLAGE PKWY STE 6
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8137
Practice Address - Country:US
Practice Address - Phone:479-936-2978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1256225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant