Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 3534 | AR |
NPI | 1073845657 |
---|---|
Provider Name | Christi Bjornberg |
First Address | Greenbrier, AR 72058-0933 |
Second Address | Conway, AR 72034-6159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 16/05/2013 |