Individual
JUSTIN BRYAN WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3114 FOX RD, JONESBORO, AR 72404-9322
(870) 933-9294
Mailing address
3114 FOX RD, JONESBORO, AR 72404-9322
(870) 933-9294
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3867
AR
Other
Enumeration date
08/18/2014
Last updated
08/19/2014
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