Individual
KASEY DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 BACK FORTY LN, EVENING SHADE, AR 72532-9004
(870) 266-3323
Mailing address
31 BACK FORTY LN, EVENING SHADE, AR 72532-9004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3969
AR
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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