Healthcare Provider Details

I. General information

NPI: 1609592054
Provider Name (Legal Business Name): JAYMEE HESS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W COLLIN RAYE DR SPC 106
DE QUEEN AR
71832-2007
US

IV. Provider business mailing address

1803 LR 51 N
FOREMAN AR
71836
US

V. Phone/Fax

Practice location:
  • Phone: 870-584-1085
  • Fax:
Mailing address:
  • Phone: 903-417-4780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4793
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: