Individual
KRISTEN RICKETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3304 S M ST, FORT SMITH, AR 72903-2903
(479) 785-4677
Mailing address
221A N 44TH ST, FORT SMITH, AR 72903-2370
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2975
AR
225200000X
Physical Therapy Assistant
PTA 2008
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5A318
BLUE CROSS BLUE SHIELD
AR
Enumeration date
11/16/2006
Last updated
07/27/2007
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