Individual
MR. JOSEPH PATRICK REAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
509 NORTH COLLEGE AVE, FAYETTEVILLE, AR 72701
(479) 444-6060
(479) 444-6060
Mailing address
509 NORTH COLLEGE AVE, FAYETTEVILLE, AR 72701
(479) 444-6060
(479) 444-6060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2052
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U129
BLUE CROSS BS
AR
01
—
73157811440
QUALCHOICE OF AR
AR
Enumeration date
07/10/2006
Last updated
07/08/2007
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