Individual
MR. RANDALL RAY IRONSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3625 W CHESTNUT ST, ROGERS, AR 72756
(479) 631-3955
(479) 631-0152
Mailing address
908 NW 8TH ST, BENTONVILLE, AR 72712
(479) 273-1141
(479) 273-3762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT396
AR
Other
Enumeration date
01/31/2006
Last updated
03/06/2008
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