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1336753011
JASON LANSDALE
WYNNE, AR
NPI
1336753011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AR PTA2079)
Enumeration Date
2020-09-01
Last Update Date
2020-09-01
Business Address
JASON LANSDALE
615 CANAL AVE E
WYNNE, AR 72396-3003
Phone number: 870-238-2233
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Mailing Address
JASON LANSDALE
1851 LEE 219
MARIANNA, AR 72360
Phone number: 870-821-1960
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