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JACOB BUCHANAN

>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1164037941

Individual Registrant:
 JACOB  BUCHANAN 
Gender: M
Sole Proprietor

Location and contact information for practice:
924 STATE HIGHWAY 77  MARION, AR 72364-9004 US
Tel: 601-650-6286  Fax: --

Contact information for business:
832 BAYOU VISTA DR  MARION, AR 72364-5006 US
Tel: 601-650-6286  Fax: --

Registration Information:
NPI: 1164037941
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
AR4516

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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