Individual
MR. CHARLES STACY WITCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
417 SW THIRD ST, WALNUT RIDGE, AR 72476-2310
(870) 886-2443
(870) 886-3289
Mailing address
907 N 74TH ST, PARAGOULD, AR 72450-6222
(870) 215-2070
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1351
AR
Other
Enumeration date
09/25/2008
Last updated
09/25/2008
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