Individual
MRS. BEVERLY JOYE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1923 E JOYCE BLVD, FAYETTEVILLE, AR 72703-5293
(479) 442-7220
Mailing address
5108 S BENT TREE DR, ROGERS, AR 72758-8030
(318) 422-7775
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4435
AR
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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