Individual
DALE HENRY MENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
3480 LANDERS RD, NORTH LITTLE ROCK, AR 72117-2541
(501) 500-3500
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2961
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
289473YQCR
MEDICARE PTAN
AR
Enumeration date
02/08/2007
Last updated
08/05/2019
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