Individual
TIFFANY DAWN WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
260 LAKE RIDGE TRL, JONESBORO, LA 71251-6621
(318) 245-4332
Mailing address
260 LAKE RIDGE TRL, JONESBORO, LA 71251-6621
(318) 245-4332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04075
LA
Other
Enumeration date
05/20/2020
Last updated
05/20/2020
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