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Individual

CRYSTAL LIKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1116 N NEW YORK AVE, BRINKLEY, AR 72021-2126
(870) 734-1155
Mailing address
15 COUNTY ROAD 6550, COLT, AR 72326-9451

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4276
AR

Other

Enumeration date
01/04/2022
Last updated
01/06/2022
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