Individual
JENNIFER L PANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
814 N SUNSET DR, FAYETTEVILLE, AR 72701-1733
(501) 230-6322
Mailing address
814 N SUNSET DR, FAYETTEVILLE, AR 72701-1733
(501) 230-6322
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4356
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
902138417
DL
AR
Enumeration date
10/30/2018
Last updated
10/30/2018
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