Individual
DANIEL WILLIAM VAN DYCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
118 JERRY SELBY DR, CROSSETT, AR 71635-4734
(870) 364-1534
Mailing address
118 JERRY SELBY DR, CROSSETT, AR 71635-4734
(870) 364-1534
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PTA 2602
AR
Other
Enumeration date
01/28/2016
Last updated
01/29/2016
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