Individual
MR. MICHAEL LEE DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.T.A.
Contact information
Practice address
156 N DAVIS ST, PEA RIDGE, AR 72751-2919
(479) 330-0187
Mailing address
156 N DAVIS ST, PEA RIDGE, AR 72751-2919
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 1550
AR
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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