Individual
MR. BRIAN E MAHONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
8907 KANIS ROAD, STE. 400, LITTLE ROCK, AR 72205
(501) 663-4320
(501) 978-1452
Mailing address
117 SCHAFER DRIVE, CARLISLE, AR 72024
(501) 425-4323
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 227
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT 227
ATHLETIC TRAINING LIC.
AR
Enumeration date
05/08/2007
Last updated
07/08/2007
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