Individual
KIMBERLY L GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1501 SE WALTON BLVD STE 109, BENTONVILLE, AR 72712-3745
(479) 273-2345
Mailing address
PO BOX 585, PEA RIDGE, AR 72751-0585
(479) 273-2345
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2023
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA2023
PTA LICENSE
AR
Enumeration date
02/28/2008
Last updated
02/28/2008
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