Individual
LORI RUNYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
908 REYNOLDS RD, BYRANT, AR 72022
(479) 967-2322
(479) 967-2876
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 967-2876
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2309
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185131721
—
AR
Enumeration date
02/08/2011
Last updated
02/08/2011
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