Individual
HANNAH MANTOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2403 MAIN DR STE 5, FAYETTEVILLE, AR 72704-5275
(479) 966-4883
Mailing address
2403 MAIN DR STE 5, FAYETTEVILLE, AR 72704-5275
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 2461
AR
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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