Healthcare Provider Details

I. General information

NPI: 1619898145
Provider Name (Legal Business Name): LADONYA MCBRYDE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SALEM RD
CONWAY AR
72034-4818
US

IV. Provider business mailing address

910 QUAIL HOLLOW RD
DOVER AR
72837-8926
US

V. Phone/Fax

Practice location:
  • Phone: 501-327-9944
  • Fax:
Mailing address:
  • Phone: 501-327-9944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA2435
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: