Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1131 | AR |
NPI | 1699985499 |
---|---|
Provider Name | Mrs. Joan Elise Hollis |
First Address | Sherwood, AR 72120-7001 |
Second Address | North Little Rock, AR 72114-1709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |