Individual
JESSELEE REYES MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSPT
Contact information
Practice address
2 CADDO CROSSING DR, GLENWOOD, AR 71943-8882
(870) 356-4954
(870) 356-4956
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-7800
(704) 824-2822
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4267
AR
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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