Individual
MICAH MAELYNN BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2611 E HERITAGE PKWY STE 3, FARMINGTON, AR 72730-6018
(479) 334-0014
Mailing address
6106 DEAN RD, ALMA, AR 72921-8140
(479) 670-0533
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4872
AR
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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