Individual
JENNIFER GRAYSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3304 S M ST, FORT SMITH, AR 72903-2903
(479) 785-4677
Mailing address
530 N 44TH ST, FORT SMITH, AR 72903-1925
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
O-T0624
AR
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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