Individual
MRS. MACKENZIE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1308 MILITARY RD, BENTON, AR 72015-2911
(501) 778-4960
(501) 778-4968
Mailing address
PO BOX 1890, BENTON, AR 72018-1890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4388
AR
Other
Enumeration date
09/07/2017
Last updated
02/16/2018
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