Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 928 | AR |
NPI | 1003096256 |
---|---|
Provider Name | Tammi Thrash |
First Address | Texarkana, AR 71854-8219 |
Second Address | Texarkana, AR 71854-1654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 05/11/2007 |