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Individual

JEFF DENISTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
505 E MATTHEWS AVE, SUITE 205, JONESBORO, AR 72401-3144
(870) 932-9567
Mailing address
709 W MATTHEWS AVE, APT 2, JONESBORO, AR 72401-3456
(870) 275-1975

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 2232
AR

Other

Enumeration date
02/23/2007
Last updated
07/08/2007
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