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Individual

DEBRA SHALEEN RUNNELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
5214 O ST, LITTLE ROCK, AR 72207-5325
(501) 477-4700
Mailing address
5214 O ST, LITTLE ROCK, AR 72207-5325
(870) 834-3772

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1444
AR
225200000X
Physical Therapy Assistant
Primary
PTA1444
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139168721
AR
Enumeration date
01/14/2011
Last updated
02/04/2022
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