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1053319715
STACEY MARIE BOSTER
RUSSELLVILLE, AR
NPI
1053319715
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Former Name
STACEY M IHLER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AR PT2554)
Enumeration Date
2005-07-07
Last Update Date
2011-09-28
Business Address
MRS. STACEY MARIE BOSTER MS,PT
3016 W. MAIN STREET SUITE 200
RUSSELLVILLE, AR 72801
Phone number: 479-967-9657
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Mailing Address
MRS. STACEY MARIE BOSTER MS,PT
1520 E 13TH ST
RUSSELLVILLE, AR 72802-7437
Phone number: 479-967-9657
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