Individual
JACOB BUCHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
924 STATE HIGHWAY 77, MARION, AR 72364-9004
(601) 650-6286
Mailing address
832 BAYOU VISTA DR, MARION, AR 72364-5006
(601) 650-6286
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4516
AR
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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