Individual
KADY SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6910 HIGHWAY 5 N, BRYANT, AR 72022-7901
(501) 585-7580
Mailing address
6910 HIGHWAY 5 N, BRYANT, AR 72022-7901
(501) 585-7580
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
3310
OK
225200000X
Physical Therapy Assistant
Primary
PTA4969
AR
Other
Enumeration date
02/18/2021
Last updated
09/26/2024
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