TANNER S GOULET

RUSSELLVILLE, AR
NPI1881061414
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: AR  PTA3934)
Enumeration Date2015-08-31
Last Update Date2015-08-31
Business Address
-- TANNER S GOULET PTA
1915 W MAIN ST
RUSSELLVILLE, AR 72801-2725
Phone number: 479-968-1198
Mailing Address
-- TANNER S GOULET PTA
500 E 3RD ST
RUSSELLVILLE, AR 72801-5204
Phone number: 479-968-1198
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