Individual
MRS. OLIVIA LACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3114 FOX RD, JONESBORO, AR 72404-9322
(870) 933-9294
Mailing address
96 COUNTY ROAD 4254, JONESBORO, AR 72404-0599
(901) 486-3288
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4496
AR
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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