Individual
MRS. KEMBRA LEA MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1801 SE J ST, BENTONVILLE, AR 72712-4295
(479) 254-5100
Mailing address
1601 CRESENT ST, BENTONVILLE, AR 72712-9411
(479) 877-9345
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 419
AR
Other
Enumeration date
02/05/2006
Last updated
09/05/2014
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