Individual
MS. KATHRYN JOAN VENEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT,MS
Contact information
Practice address
1112 S 48TH ST STE B, SPRINGDALE, AR 72762-5886
(479) 751-3900
Mailing address
PO BOX 871, TONTITOWN, AR 72770-0871
(479) 751-3900
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1932
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135578721
—
AR
01
—
5U231
ABCBS PROVIDER NUMBER
AR
Enumeration date
05/09/2007
Last updated
07/28/2008
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