Individual
DANTANESE RIDGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6301 S HAZEL ST, PINE BLUFF, AR 71603-7818
(870) 534-8153
Mailing address
238 CARPENTER RD, MONTICELLO, AR 71655-9190
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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