Individual
LAUREN R WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
427 W CENTERTON BLVD, CENTERTON, AR 72719-8701
(479) 795-1260
(479) 795-1261
Mailing address
806 N 16TH ST, ROGERS, AR 72756-2655
(479) 276-2093
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4013
AR
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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