Individual
LISA MICHELLE MOSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
214 HOPE LANDING RD, EL DORADO, AR 71730-8725
(870) 862-0500
(870) 862-2100
Mailing address
1872 N TATE RD, EL DORADO, AR 71730-6035
(870) 918-0695
(870) 862-2100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1777
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA1777
PTA LICENSE NUMBER
AR
Enumeration date
08/08/2016
Last updated
08/08/2016
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