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General NPI Number Information
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NPI Number | 1255980306
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Entity Type | Individual
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Provider Name | LANELTA JANE STONE PTA
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Gender | Female
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 8 WILSON FARM RD
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City | GREENBRIER
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State | AR
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Zip | 72058-9310
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Country | US
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Telephone | 501-581-6045
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Fax | 501-325-0909
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Provider Business Mailing Address
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Address Line | PO BOX 933
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City | GREENBRIER
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State | AR
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Zip | 72058-0933
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Country | US
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Telephone | 501-501-6045
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Fax | 501-325-0909
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA851
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License Number State | AR
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