Individual
VERA MICHELLE DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
120 NIX RIDGE RD, ASH FLAT, AR 72513-9017
(870) 528-3097
Mailing address
PO BOX 50, SAFFELL, AR 72572-0050
(870) 528-3097
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1469
AR
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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