Individual
MYLES JERRELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2275 MOIX BLVD APT 33212, CONWAY, AR 72034-7091
(501) 802-4390
Mailing address
2275 MOIX BLVD APT 33212, CONWAY, AR 72034-7091
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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