Individual
ELEASAH MCNABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 RUSSELL ROAD, RUSSELLVILLE, AR 72801
(479) 967-2322
(479) 967-2876
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2769
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155115721
—
AR
Enumeration date
03/27/2007
Last updated
04/09/2012
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