Individual
MRS. HALEY MICHELLE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4340 SR 164 W, DOVER, AR 72837-8371
(479) 970-9751
Mailing address
4340 SR 164 W, DOVER, AR 72837-8371
(479) 970-9751
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4068
AR
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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