Individual
MICHAEL BRYAN PADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
92 QUAPAW TRL, JACKSONVILLE, AR 72076-8991
(501) 626-5825
Mailing address
92 QUAPAW TRL, JACKSONVILLE, AR 72076-8991
(501) 626-5825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1472
—
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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