Autumn Reyes Bankston
Individual provider Active NPI Physical Therapy Assistant · Jonesboro, AR
NPI 1295094142 · NPPES record last updated May 14, 2012
Key facts
- NPI
- 1295094142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2588 (AR)
- Practice address
- 3423 E Highland Dr
Ste. a
Jonesboro, AR 72401-6404 - Phone
- (870) 336-0021
- Fax
- (870) 736-0022
- NPI assigned
- May 14, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2588 | AR | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2588 | AR | Yes |
Addresses
Primary practice location
3423 E Highland Dr
Ste. a
Jonesboro, AR 72401-6404
Mailing address
3423 E Highland Dr
Ste. a
Jonesboro, AR 72401-6404
Phone (870) 336-0021
Other providers in Jonesboro, AR
- Virginia Baltz
- Nicole Bane
- Heather Lynn Banks
- Javana Latrice Banks
- Twyla Jane Banks
- Kasey Michelle Banning
- Baptist Memorial Hospital-Jonesboro Inc
- Baptist Memorial Hospital-Jonesboro Inc
- Charlotte R Barajas
- Bethany Barber
All providers in Jonesboro, AR · Physical Therapy Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.