Individual
JENNIFER RENEE INNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
679 NORTH MAIN STREET, SALEM, AR 72576
(870) 895-2691
(870) 895-3306
Mailing address
PO BOX 517, SALEM, AR 72576-0517
(870) 895-2691
(870) 895-3306
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2287
AR
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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