Individual
MASON KONNOR CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
Mailing address
400 PHILLIPS RD, POTTSVILLE, AR 72858-8838
(479) 968-2525
(479) 968-2539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4875
AR
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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