Individual
MICHAEL DAMON HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
1101 JACKSON ST SW, GRAVETTE, AR 72736-9121
(479) 344-6740
Mailing address
10542 BLUE JAY RD, PEA RIDGE, AR 72751-2724
(870) 834-5332
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA967
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 967
ARKANSAS PHYSICAL THERAPY BOARD
AR
Enumeration date
03/16/2007
Last updated
01/19/2011
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