Individual
MS. CORALIE WATTS MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3231 MAIN ST STE 3, BRYANT, AR 72022-9201
(501) 847-0500
(501) 847-0508
Mailing address
3231 MAIN ST STE 3, BRYANT, AR 72022-9201
(501) 847-0500
(501) 847-0508
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT904
AR
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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