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1821564873
JONATHAN BLAKE RANEY
MONTICELLO, AR
NPI
1821564873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AR 4359)
Enumeration Date
2018-10-17
Last Update Date
2018-10-17
Business Address
JONATHAN BLAKE RANEY PTA
778 SCOGIN DR
MONTICELLO, AR 71655-5729
Phone number: 870-460-3540
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Mailing Address
JONATHAN BLAKE RANEY PTA
205 BRADLEY ROAD 42 W
HERMITAGE, AR 71647-9279
Phone number: 870-820-6209
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