Individual
MISS CHRISTA LEANNE TACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 N BEVERLY AVE, SHERWOOD, AR 72120-4666
(501) 838-4771
Mailing address
301 N BEVERLY AVE, SHERWOOD, AR 72120-4666
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR 1688
AR
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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