Individual
JASON LANSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 CANAL AVE E, WYNNE, AR 72396-3003
(870) 238-2233
(870) 208-8255
Mailing address
1851 LEE 219, MARIANNA, AR 72360
(870) 821-1960
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2079
AR
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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