Individual
MR. NATHAN LEE HARALSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/L, CDA
Contact information
Practice address
2860 I-55 SERVICE ROAD, SUITE C, MARION, AR 72364
(870) 514-6224
Mailing address
1115 CLEMENT RD, WEST MEMPHIS, AR 72301-2451
(870) 514-6224
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT430
AR
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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