Individual
JOHN RYAN TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2 TUFF ST, ASH FLAT, AR 72513-9755
(870) 994-7778
Mailing address
PO BOX 296, ASH FLAT, AR 72513-0296
(870) 994-7778
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A1151
AR
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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