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Individual

MISTY VICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
719 DETROIT AVE, DANVILLE, AR 72833-9607
(479) 495-6252
(479) 495-6336
Mailing address
PO BOX 639, DANVILLE, AR 72833-0639
(479) 495-6252
(479) 495-6336

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2662
AR

Other

Enumeration date
10/28/2014
Last updated
10/28/2014
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