Individual
JANA M GREENWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2811 LONGVIEW DR, SUITE C, JONESBORO, AR 72401-5919
(870) 974-9114
(870) 974-9184
Mailing address
2811 LONGVIEW DR, SUITE C, JONESBORO, AR 72401-5919
(870) 974-9114
(870) 974-9184
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR978
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129139721
—
AR
01
—
5W191
BLUE CROSS BLUE SHIELD
AR
Enumeration date
02/12/2007
Last updated
07/08/2007
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