Individual
JESSICA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
404 S BRADLEY ST, WARREN, AR 71671-3459
(870) 226-4190
Mailing address
RT. 2, BOX 256 E., HAMPTON, AR 71744
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2132
AR
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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