Individual
JUSTIN HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
582 HIGHWAY 365 STE 3, MAYFLOWER, AR 72106-9525
(501) 470-3500
(501) 470-3502
Mailing address
582 HIGHWAY 365 STE 3, MAYFLOWER, AR 72106-9525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2700
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR2700
STATE LICENSE
AR
Enumeration date
06/24/2015
Last updated
06/24/2015
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