Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PTA-4127 | AR |
NPI | 1003375429 |
---|---|
Provider Name | Mrs. Jordan Ramm |
First Address | Jonesboro, AR 72404-7585 |
Second Address | Jonesboro, AR 72404-0797 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2019 |
Last Update Date | 15/03/2019 |