Jennifer Renee Innis, PTA

NPI #1144465485 in Salem, Arkansas

Provider Information

NPI Number: 1144465485
Entity Type: Individual
Name: Jennifer Renee Innis, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Dec 15, 2008
Last Updated: Dec 15, 2008

Practice Location

Address: 679 NORTH MAIN STREET
City: Salem
State: Arkansas
ZIP Code: 72576
Phone: (870) 895-2691

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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