Individual
MRS. LIZA JOVELLANO CORNELIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3998 HIGHWAY 1 N, FORREST CITY, AR 72335-7637
(870) 633-2120
Mailing address
3908 CHARLESTON DR, JONESBORO, AR 72404-9160
(870) 933-8006
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2301
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138340721
—
AR
Enumeration date
05/23/2007
Last updated
06/17/2008
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