Individual
JACQUELINE MICHELLE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
110 W 13TH ST, MURFREESBORO, AR 71958-9501
(870) 285-2168
Mailing address
140 RAILROAD ST, P.O. BOX 564, TYRONZA, AR 72386-9416
(870) 514-9722
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
4268
NC
225200000X
Physical Therapy Assistant
Primary
PTA 2347
AR
Other
Enumeration date
10/23/2009
Last updated
10/24/2009
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