Individual
MATTHEW STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
9601 I 630 EXIT 7, BAPTIST HEALTH REHAB INSTITUTE, LITTLE ROCK, AR 72205-7299
(501) 202-7589
(501) 202-7141
Mailing address
1914 U STREET, BENTON, AR 72015
(501) 580-9131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1782
AR
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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