Individual
JACOB TOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
707 ELDRIDGE AVE E, WYNNE, AR 72396-4032
(870) 208-8989
(870) 208-8989
Mailing address
707 ELDRIDGE AVE E, WYNNE, AR 72396-4032
(870) 208-8989
(870) 208-8989
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 3890
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 3890
PHYSICAL THERAPIST
AR
Enumeration date
10/20/2014
Last updated
10/20/2014
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