Provider Demographics
NPI:1689436255
Name:COMBS, JAYCEE
Entity Type:Individual
Prefix:MRS
First Name:JAYCEE
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MUSGRAVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-2700
Mailing Address - Country:US
Mailing Address - Phone:870-845-5600
Mailing Address - Fax:870-845-5605
Practice Address - Street 1:500 MUSGRAVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-2700
Practice Address - Country:US
Practice Address - Phone:870-845-5600
Practice Address - Fax:870-845-5605
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA4912225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty