Individual
JASON TRAXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
325 S 6TH PL, LOWELL, AR 72745-9704
(479) 770-0700
Mailing address
325 S 6TH PL, LOWELL, AR 72745-9704
(479) 770-0700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT475
AR
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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