Individual
MICHAEL DEAN VANTRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1409 HIGHWAY 62 65 N, STE 4, HARRISON, AR 72601-1911
(870) 704-4076
(870) 741-0089
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2007019796
MO
225200000X
Physical Therapy Assistant
Primary
PTA 2390
AR
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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