Individual
BETHANY D MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2808 FOX MEADOW LN, JONESBORO, AR 72404-9346
(870) 932-4245
(870) 931-4457
Mailing address
2808 FOX MEADOW LN, JONESBORO, AR 72404-9346
(870) 932-4245
(870) 931-4457
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 3349
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186279721
—
AR
Enumeration date
03/28/2011
Last updated
05/09/2011
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