Individual
TANYA RENEE MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICALTHERAPY ASST
Contact information
Practice address
4505 N RUDY RD, VAN BUREN, AR 72956-9062
(479) 474-4011
(479) 474-4044
Mailing address
4110 SO P ST, FORT SMITH, AR 72903
(479) 783-2540
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1363
AR
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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