Individual
TOMMY JOE WILLHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528
Mailing address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160740526
—
AR
05
—
160751724
—
AR
05
—
160761142
—
AR
Enumeration date
02/17/2010
Last updated
02/17/2010
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