Individual
CARL NANNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
297 W KIEHL AVE, SHERWOOD, AR 72120-2815
(678) 571-0033
(678) 802-7401
Mailing address
297 W KIEHL AVE, SHERWOOD, AR 72120-2815
(678) 571-0033
(678) 802-7401
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-1120
AR
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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