Individual
JASE CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 W CHESTNUT ST, ROGERS, AR 72756-0351
(479) 246-0101
Mailing address
17792 BLUFFVIEW DR, SPRINGDALE, AR 72764-9293
(870) 200-0037
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1501
AR
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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