Individual
CAMILA ROSE ANTIQUIERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 S AVALON ST, WEST MEMPHIS, AR 72301-4109
(870) 400-3481
Mailing address
1350 S AVALON ST APT 4, WEST MEMPHIS, AR 72301-6277
(870) 702-6940
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT2791
AR
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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