Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA4675 | AR |
NPI | 1003581356 |
---|---|
Provider Name | Sarah May |
First Address | Wynne, AR 72396-4026 |
Second Address | Wynne, AR 72396-4026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 10/08/2021 |