Individual
TAMMARA IVY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
706 OAK GROVE ST, MOUNTAIN VIEW, AR 72560-8601
(870) 269-7059
Mailing address
2650 PRIM RD, PRIM, AR 72130-9526
(870) 615-1555
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1920
AR
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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