NPI 1144637927

Jason Kyle Carruth, ATC

Practitioner Athletic Trainer Conway, AR

Practice location

Address: 550 Club Ln Suite 2, Conway, AR 72034-3681
Phone: (501) 932-0814
Mailing address: 68 Donna Kay Dr, Greenbrier, AR 72058-9579

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT 084 (AR)

Other Specialist/Technologist providers in Arkansas →

Registry record

NPI: 1144637927
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jul 2014
Record last updated: 14 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.