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1942676010
KELSIE WIDEMAN
FAYETTEVILLE, AR
NPI
1942676010
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: AR PT4030)
Enumeration Date
2015-08-12
Last Update Date
2015-08-12
Business Address
KELSIE WIDEMAN
2474 E JOYCE BLVD STE 2
FAYETTEVILLE, AR 72703-4519
Phone number: 479-521-8326
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Mailing Address
KELSIE WIDEMAN
2474 E JOYCE BLVD STE 2
FAYETTEVILLE, AR 72703-4519
Phone number: 479-521-8326
Copy
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