Individual
MS. RUSTI L WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1200 S ELMIRA AVE, RUSSELLVILLE, AR 72802-9646
(479) 968-7118
(479) 968-8628
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1597
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154573721
—
AR
01
—
PT1597
STATE LICENSE NUMBER
AR
Enumeration date
08/12/2008
Last updated
04/20/2022
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