Individual
NICKOLAS COONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 S GILES AVE, GENTRY, AR 72734-9320
(479) 736-8562
Mailing address
PO BOX 195, GENTRY, AR 72734-0195
(479) 640-3404
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT-A973
AR
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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