Individual
MR. STANLEY JENKINS HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4801 FAIRWAY AVE, N LITTLE ROCK, AR 72116-8009
(501) 758-1300
(501) 758-1316
Mailing address
4801 FAIRWAY AVE, N LITTLE ROCK, AR 72116-8009
(501) 758-1300
(501) 758-1316
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
775
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129283721
—
AR
01
—
5G468
MEDICARE GROUP
AR
01
—
5S488
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/28/2006
Last updated
08/22/2011
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