Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT3748 | AR |
NPI | 1184010506 |
---|---|
Provider Name | Karmen Lawson |
First Address | Conway, AR 72034-7830 |
Second Address | Conway, AR 72034-7830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 13/04/2015 |