Provider Demographics
NPI:1407129505
Name:STONER, LENA ANNETTE (PTA)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:ANNETTE
Last Name:STONER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 CORDOVA LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-7814
Mailing Address - Country:US
Mailing Address - Phone:870-761-1024
Mailing Address - Fax:
Practice Address - Street 1:5520 CORDOVA LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-7814
Practice Address - Country:US
Practice Address - Phone:870-761-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO117674225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant