Provider Demographics
NPI:1568851764
Name:GARLAND, JASON (OT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:GARLAND
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 STONE ST
Mailing Address - Street 2:207
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1218 STONE ST
Practice Address - Street 2:207
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4528
Practice Address - Country:US
Practice Address - Phone:870-219-1086
Practice Address - Fax:870-275-6822
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2355225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AROTR2355OtherARKANSAS STATE MEDICAL BOARD