Individual
DONNA CARLENE DEVAZIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
620 THOMPSON AVE, WEST MEMPHIS, AR 72301-3257
(870) 702-4911
(870) 702-6386
Mailing address
1504 CHESTNUT ST, FORREST CITY, AR 72335-1916
(870) 633-5288
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1715
AR
Other
Enumeration date
11/17/2006
Last updated
07/09/2007
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