Individual
MS. KEELY ROUTH SPICER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3130 N MARKET AVE, FAYETTEVILLE, AR 72703-3516
(479) 595-0599
(479) 935-9875
Mailing address
1764 E TOWNSHIP ST, FAYETTEVILLE, AR 72703-4160
(479) 790-0140
(479) 935-9875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2767
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156625721
—
AR
Enumeration date
06/05/2006
Last updated
04/23/2009
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