Individual
HOLLY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3801 MAIN DR STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Mailing address
3801 MAIN DR STE B, FAYETTEVILLE, AR 72704-6364
(479) 856-6400
(479) 856-6623
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3601
AR
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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