Individual
JACKI LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
321 SECTION LINE RD, SUITE E, HOT SPRINGS, AR 71913-6482
(501) 520-0504
(501) 520-0245
Mailing address
321 SECTION LINE RD, SUITE E, HOT SPRINGS, AR 71913-6482
(501) 520-0504
(501) 520-0245
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1293
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1293
PTA LICENSE
AR
Enumeration date
01/06/2011
Last updated
02/01/2014
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