Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA 2205 | AR |
NPI | 1013103647 |
---|---|
Provider Name | Mrs. Joyce Atchley |
First Address | Mena, AR 71953-9545 |
Second Address | Mena, AR 71953-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 18/09/2007 |