Individual
DARRELL R GANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6040 BEAVER CREEK, JONESBORO, AR 72404
(870) 219-2107
Mailing address
6040 BEAVER CREEK LN, JONESBORO, AR 72404-9558
(870) 219-2107
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2401
AR
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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