Most Relevant Information
Provider Data
| NPI Number: | 1003543695 |
| Provider Name: | JORDAN PHILIP THRASHER |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 201939 |
Most Important Dates
| Enumeration Date: | 08/03/2022 |
| Last Updated: | 08/03/2022 |
Provider Practice Location
3117 PARTIPILO ST
MOUNTAIN HOME
AR
726535855
Practice Location Phone/Fax
| Phone: | 5012064555 |
| Fax: |
Provider Mailing Location
3117 PARTIPILO ST
MOUNTAIN HOME
AR
726535855
Provider Mailing Phone/Fax
| Phone: | 5012064555 |
| Fax: |