Individual
DR. RONALD L KANTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4200 JENNY LIND RD, SUITE A, FORT SMITH, AR 72901-7660
(479) 484-1010
(479) 785-9916
Mailing address
PO BOX 11768, FORT SMITH, AR 72917-1768
(479) 484-1010
(479) 785-9916
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036-108668
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161909003
—
AR
Enumeration date
01/20/2006
Last updated
11/30/2009
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