Individual
MRS. AMANDA KAYE EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 CHILDRENS WAY, SLOT 512-39, LITTLE ROCK, AR 72202-3500
(501) 526-8706
(501) 526-8740
Mailing address
1 CHILDRENS WAY, SLOT 512-39, LITTLE ROCK, AR 72202-3500
(501) 526-8706
(501) 526-8740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2715
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197090795
—
AR
Enumeration date
06/13/2013
Last updated
06/13/2013
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