Individual
SUSAN STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
216 MAIN ST, LAKE VILLAGE, AR 71653-1916
(870) 265-3950
(870) 265-2525
Mailing address
216 MAIN ST, LAKE VILLAGE, AR 71653-1916
(870) 265-3950
(870) 265-2525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA453
AR
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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