Individual
MEYNARD CANLAS PANTIG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR L
Contact information
Practice address
816 N MAIN ST, HARRISON, AR 72601-2915
(870) 743-5573
(870) 743-5974
Mailing address
PO BOX 841, HARRISON, AR 72602-0841
(870) 743-5573
(870) 743-5974
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1888
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X724
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/21/2005
Last updated
07/08/2007
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