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NPI Code Detail

MEDICARE: JACI AMMONS

MEDICARE: JACI AMMONS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistCP049268TAR

General Provider Information

NPI Number : 1336004985
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACI AMMONS
Provider Business Mailing Address
First Line : 800 FAIR PARK BLVD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-1720
Country : US
Telephone Number : 501-500-3500
Fax Number : 501-904-3620
Provider Business Practice Location Address
First Line : 800 FAIR PARK BLVD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-1720
Country : US
Telephone Number : 501-500-3500
Fax Number : 501-904-3620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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Directions to “ JACI AMMONS ” Practice Location

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