Individual
REID MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2301 S 56TH ST, SIUTE 104, FORT SMITH, AR 72903-3755
(479) 739-5555
Mailing address
5105 GARY ST, FORT SMITH, AR 72903-4638
(479) 739-5555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2163
AR
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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