Individual
MS. LAURA FAWN PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
363 MCKNIGHT AVE, WEST FORK, AR 72774
(479) 751-3900
Mailing address
4774 W CANYON RUN DR, FAYETTEVILLE, AR 72704-3401
(479) 857-0644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2255
—
235Z00000X
Speech-Language Pathologist
SP#P8343
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BLUE CROSS
5U688
AR
Enumeration date
01/30/2007
Last updated
04/19/2023
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