Individual
CHRISTIE SUMMERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2474 E. JOYCE BLVD, SUITE 2, FAYETTEVILLE, AR 72703
(479) 521-8326
Mailing address
2474 E. JOYCE BLVD, SUITE 2, FAYETTEVILLE, AR 72703
(479) 521-8326
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT3013
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT3013
AR PT LICENSE
AR
Enumeration date
09/25/2007
Last updated
09/25/2007
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