Individual
JASON DALE RYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 W 7TH ST, LITTLE ROCK, AR 72205-5446
(501) 257-6550
Mailing address
901 HIGHWAY 88, LONSDALE, AR 72087-9670
(501) 326-5679
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L051729
AR
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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