Individual
ELIZABETH JOVON GLADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
104 MILLER ST, BERRYVILLE, AR 72616-3300
(479) 253-1815
Mailing address
426A BLACKWELL FERRY RD, KIRBYVILLE, MO 65679-8302
(870) 718-8799
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2125
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161555721
—
AR
Enumeration date
04/11/2007
Last updated
10/02/2018
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