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1316203201
REGINA GERTRUDE BRANTLEY
MTN HOME, AR
NPI
1316203201
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AR OT-A338)
Enumeration Date
2012-04-05
Last Update Date
2012-04-05
Business Address
Ms. REGINA GERTRUDE BRANTLEY COTA/L
161 SUNRISE CT
MTN HOME, AR 72653
Phone number: 870-424-0909
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Mailing Address
Ms. REGINA GERTRUDE BRANTLEY COTA/L
161 SUNRISE CT
MOUNTAIN HOME, AR 72653-8057
Phone number: 870-424-0909
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